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Yan X, Bedillion MF, Claus ED, Huang-Pollock C, Ansell EB. Sex differences in the prospective association of excessively long reaction times and hazardous cannabis use at six months. Addict Behav Rep 2024; 20:100558. [PMID: 39027408 PMCID: PMC11252613 DOI: 10.1016/j.abrep.2024.100558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 06/02/2024] [Accepted: 06/18/2024] [Indexed: 07/20/2024] Open
Abstract
Objective The neurocognitive risk mechanisms predicting divergent outcomes likely differ between men and women who use cannabis recreationally. Increasingly, the use of descriptive distributions including the ex-Gaussian has been applied to draw stronger inferences about neurocognitive health in clinical populations. The current project examines whether the long tail of reaction times (RTs) in a distribution, as characterized by the ex-Gaussian parameter tau which may represent difficulty with the regulation of arousal, predicts problematic cannabis use 6 months later in those who use cannabis recreationally, and whether sex moderates these prospective associations. Method Young adults (ages 18-30, mean age 20.5 years, N =159, 57.2% women, 69.2% Caucasian) who recreationally used cannabis either occasionally (at least once per month) or frequently (three times or more per week) completed the Stroop Color-Word Task at baseline. Ex-Gaussian parameter tau was estimated for each participant. Self-report of hazardous cannabis use (CUDIT-R) and dysregulation of negative (DERS) and positive emotions (DERS-Positive) were obtained at baseline and 6-month follow-up. Results For those with larger tau at baseline, being a man (but not a woman) was associated with increased difficulty regulating positive emotions concurrently (b = -0.01, F (1,159) = 5.48, p = 0.02), and with hazardous cannabis use six months later (b = -0.007, F (1,159) = 4.42, p = 0.037) after controlling for baseline hazardous cannabis use. Conclusions Excessively long RTs during cognitive performance may help characterize men at risk for increased hazardous use, which contributes to understanding between-sex heterogeneity in pathways towards cannabis use disorders.
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Affiliation(s)
- Xu Yan
- Department of Psychology, The Pennsylvania State University, United States
| | - Margaret F. Bedillion
- Department of Biobehavioral Health, The Pennsylvania State University, United States
| | - Eric D. Claus
- Department of Biobehavioral Health, The Pennsylvania State University, United States
| | | | - Emily B. Ansell
- Department of Biobehavioral Health, The Pennsylvania State University, United States
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2
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Roos CR, Kiluk B, Carroll KM, Bricker JB, Mun CJ, Sala M, Kirouac M, Stein E, John M, Palmer R, DeBenedictis A, Frisbie J, Haeny AM, Barry D, Fucito LM, Bowen S, Witkiewitz K, Kober H. Development and initial testing of mindful journey: a digital mindfulness-based intervention for promoting recovery from Substance use disorder. Ann Med 2024; 56:2315228. [PMID: 38382111 PMCID: PMC10883107 DOI: 10.1080/07853890.2024.2315228] [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: 10/19/2023] [Accepted: 01/30/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND/OBJECTIVES There is a great unmet need for accessible adjunctive interventions to promote long-term recovery from substance use disorder (SUD). This study aimed to iteratively develop and test the initial feasibility and acceptability of Mindful Journey, a novel digital mindfulness-based intervention for promoting recovery among individuals with SUD. PATIENTS/MATERIALS Ten adults receiving outpatient treatment for SUD. METHODS Phase 1 (n = 5) involved developing and testing a single introductory digital lesson. Phase 2 included a separate sample (n = 5) and involved testing all 15 digital lessons (each 30- to 45-minutes) over a 6-week period, while also receiving weekly brief phone coaching for motivational/technical support. RESULTS Across both phases, quantitative ratings (rated on a 5-point scale) were all at or above a 4 (corresponding with 'agree') for key acceptability dimensions, such as usability, understandability, appeal of visual content, how engaging the content was, and helpfulness for recovery. Additionally, in both phases, qualitative feedback indicated that participants particularly appreciated the BOAT (Breath, Observe, Accept, Take a Moment) tool for breaking down mindfulness into steps. Qualitative feedback was used to iteratively refine the intervention. For example, based on feedback, we added a second core mindfulness tool, the SOAK (Stop, Observe, Appreciate, Keep Curious), and we added more example clients and group therapy videos. In Phase 2, 4 out of 5 participants completed all 15 lessons, providing initial evidence of feasibility. Participants reported that the phone coaching motivated them to use the app. The final version of Mindful Journey was a smartphone app with additional features, including brief on-the-go audio exercises and a library of mindfulness practices. Although, participants used these additional features infrequently. CONCLUSIONS Based on promising initial findings, future acceptability and feasibility testing in a larger sample is warranted. Future versions might include push notifications to facilitate engagement in the additional app features.
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Affiliation(s)
- Corey R. Roos
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Brian Kiluk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Kathleen M. Carroll
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Chung Jung Mun
- Edson College of Nursing and Health Innovation, AZ State University, Tempe, AZ, USA
| | - Margarita Sala
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Megan Kirouac
- Center on Alcohol, Substance Use, and Addiction, Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Elena Stein
- Medical Center, VA Puget Sound Health Care System, Seattle, VA, USA
| | - Maya John
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robert Palmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, University of New Mexico, Albuquerque, NM, USA
| | - Andrew DeBenedictis
- Department of Mental Health Counseling, Boston College, Chestnut Hill, MA, USA
| | | | - Angela M. Haeny
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Declan Barry
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lisa M. Fucito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sarah Bowen
- Department of Psychology, Pacific University
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addiction, Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Hedy Kober
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Mansueto G, Palmieri S, Sassaroli S, Ruggiero GM, Caselli G, Calligaro D, Manigrasso A, Nikčevic A, Spada MM. Emotion dysregulation in participants with substance use disorders: A metacognitive perspective. J Affect Disord 2024; 363:63-71. [PMID: 39038617 DOI: 10.1016/j.jad.2024.07.144] [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: 04/15/2024] [Revised: 06/24/2024] [Accepted: 07/17/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Using the metacognitive model of emotion dysregulation as a basis, this study explored whether, among participants with substance use disorders (SUDs), metacognitive beliefs and repetitive negative thinking were associated with emotion dysregulation. METHODS 127 participants with SUDs and 127 controls without SUDs were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, and depression were assessed. t-tests, Mann-Whitney tests, logistic regression, correlation, and hierarchal regression analyses were run. RESULTS Participants with SUDs reported significantly higher levels of emotion dysregulation, positive beliefs about worry, beliefs about the need to control thoughts, rumination, and worry, compared to controls without SUDs. Among participants with SUDs negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, beliefs about the need to control thoughts, rumination, and worry were significantly associated with an increase of emotion dysregulation. LIMITATIONS The cross-sectional design. CONCLUSION Emotion dysregulation, metacognitive beliefs, and repetitive negative thinking may contribute to increase the risk of substance use. Among participants with SUDs emotion dysregulation is associated with the tendency to endorse dysfunctional metacognitive beliefs and report repetitive negative thinking. Metacognitive beliefs and repetitive negative thinking could be a suitable therapeutic target to reduce emotion dysregulation among participants with SUDs.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy; School of Applied Sciences, London South Bank University, London, UK.
| | - Sara Palmieri
- School of Applied Sciences, London South Bank University, London, UK; Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Sandra Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Gabriele Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Dalila Calligaro
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Antonella Manigrasso
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Ana Nikčevic
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Kingston upon Thames, UK
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Messman BA, Compton SE, Majeed I, Weiss NH, Contractor AA. Beyond the mean: examining associations between intraindividual variability in posttraumatic stress disorder symptoms and posttrauma reckless behaviors. ANXIETY, STRESS, AND COPING 2024; 37:615-631. [PMID: 38268223 PMCID: PMC11266525 DOI: 10.1080/10615806.2024.2307465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/07/2024] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND/OBJECTIVES Posttrauma reckless behaviors have been linked to the onset and exacerbation of posttraumatic stress disorder (PTSD) symptoms. However, PTSD symptoms fluctuate across time, triggered by environmental stimuli in daily life, referred to as (intraindividual) variability in PTSD symptoms. DESIGN We utilized experience sampling methods to investigate associations between engagement in posttrauma reckless behaviors and variability in PTSD symptoms and the moderating role of emotion dysregulation in this association. METHODS Data from 166 trauma-exposed university students (Mage = 21.43 ± 5.07, 85.4% women) were collected between January 2019 to August 2020. Participants completed baseline and follow-up surveys to assess engagement in posttrauma reckless behaviors and daily surveys (10-days) to assess variability in PTSD symptoms. Results. Analyzes indicated greater baseline engagement in posttrauma reckless behaviors was associated with greater 10-day variability in PTSD symptoms (β = 0.23, p = .031), and baseline emotion dysregulation moderated this association (β = -0.33, p = .003). Additionally, greater 10-day variability in PTSD symptoms was associated with greater follow-up engagement in posttrauma reckless behaviors (β = 0.14, p = .045). CONCLUSIONS Findings substantiate the interplay between engagement in posttrauma reckless behaviors and daily fluctuations in PTSD symptoms and support therapeutically targeting both engagement in posttrauma reckless behaviors and emotion dysregulation to impact PTSD symptoms.
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Affiliation(s)
- Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Sidonia E Compton
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Ifrah Majeed
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Bocci Benucci S, Di Gesto C, Ghinassi S, Casale S, Fioravanti G. Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis. J Sex Med 2024:qdae101. [PMID: 39183145 DOI: 10.1093/jsxmed/qdae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/20/2024] [Accepted: 07/30/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (β = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; β = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.
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Affiliation(s)
- Sara Bocci Benucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Cristian Di Gesto
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, 50135, Italy
| | - Simon Ghinassi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, 50135, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, 50135, Italy
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Phillips AR, Halligan SL, Lavi I, Macleod JAA, Robinson S, Wilkins D, Hiller RM. A Scoping Review of Factors Associated With the Mental Health of Young People Who Have "Aged Out" of the Child Welfare System. TRAUMA, VIOLENCE & ABUSE 2024; 25:1780-1798. [PMID: 37776530 PMCID: PMC11155215 DOI: 10.1177/15248380231196107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Young people who grow up in care and then exit care around the age of 18 (care-leavers) are a particularly vulnerable group, at increased risk for mental health problems even relative to other care-experienced groups. Yet, little is understood about the factors underpinning this association. We used scoping review methods to synthesize the quantitative and qualitative literature on factors that are associated with mental health problems for care-leavers. Following rigorous methods, we systematically searched three scientific databases spanning psychology and social care and identified 23 peer-reviewed studies for inclusion. This review highlights the heterogeneity of this research, in terms of methodology and topics investigated. Topics included are as follows: pre-care maltreatment, care-related experiences, psychological factors (emotion regulation), social support, education, and adult functioning (e.g., housing, finances, employment). We found mixed and inconsistent findings across research studies. The strongest evidence-base is around the influence of social support upon the mental health of recent care-leavers, though methodological problems are discussed. The field benefits from several large-scale observational and longitudinal research studies. However, there is an over-reliance upon retrospective reporting, and the use of unvalidated measures is common. It is apparent that there are significant gaps in our current understanding of the mental health of care-leavers, in particular around modifiable factors. We discuss potential directions for future empirical research, both in terms of methodology and factors investigated.
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Affiliation(s)
| | | | | | - John A. A. Macleod
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, UK
- The University of Bristol, UK
| | | | | | - Rachel M. Hiller
- University College London, UK
- Anna Freud Centre for Children and Families, London, UK
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7
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Snaychuk LA, Dermody SS, Tabri N, Basedow CA, Kim HS. Co-occurring compulsive sexual behaviour in an inpatient substance use population: Clinical correlates and influence on treatment outcomes. J Behav Addict 2024; 13:676-686. [PMID: 38905000 PMCID: PMC11220798 DOI: 10.1556/2006.2024.00035] [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: 03/27/2024] [Revised: 05/16/2024] [Accepted: 06/05/2024] [Indexed: 06/23/2024] Open
Abstract
Background and Aims Many individuals with substance use disorders (SUDs) present with co-occurring mental health disorders and other addictions, including behavioral addictions (BAs). Though several studies have investigated the relationship between SUDs and BAs, less research has focused specifically on compulsive sexual behaviour (CSB). Given that poly-addiction can hinder treatment outcomes, it is necessary to better understand the impact of co-occurring CSB and SUD. Therefore, the current study aimed to 1) determine the rate of CSB in a sample seeking treatment for SUDs, 2) identify demographic and clinical correlates of co-occurring CSB, and 3) to determine if co-occurring CSB impacts treatment outcomes for SUD. Methods Participants were 793 adults (71.1% men) ranging in age from 18-77 (M = 38.73) at an inpatient treatment facility for SUDs who were assessed for CSB upon admission into treatment. Participants completed a battery of questionnaires upon admission and at discharge to assess psychological and addiction symptoms. Results Rates of CSB were 24%. Younger age and being single were associated with greater CSB. Mental distress and addiction symptoms were higher in participants with CSB. Predictors of CSB severity included greater symptoms of traumatic stress and interpersonal dysfunction. Rates of treatment completion were similar between participants with and without CSB. Discussion and Conclusions These results highlight several clinical and demographic correlates of CSB amongst individuals in treatment for SUD. However, CSB was not associated with poorer treatment outcomes. Further identifying characteristics associated with CSB can help clinicians identify individuals who may be at higher risk.
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Affiliation(s)
- Lindsey A. Snaychuk
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
- EHN Canada, Toronto, Canada
| | - Sarah S. Dermody
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Canada
| | | | - Hyoun S. Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, Canada
- Department of Psychology, University of Calgary, Calgary, Canada
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Chang YC, Rubey RL, Ladd BO. Brief emotion regulation strategies to reduce alcohol craving: Mediating role of state difficulties in emotion regulation. Behav Res Ther 2024; 177:104527. [PMID: 38581778 DOI: 10.1016/j.brat.2024.104527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE This study experimentally compared the effects of emotion regulation (ER) strategies on alcohol craving and examined the mediating effect of state difficulties in emotion regulation (S-DER) on the relationship between negative/positive emotion and alcohol craving. METHOD 417 participants (76.74% women, Mage = 20.76 years) endorsing past-month heavy/binge drinking were randomly assigned to one of four ER conditions (positive reappraisal, distancing, distraction, and acceptance). Participants completed state assessments, including negative/positive emotion, S-DER, and alcohol craving, prior to (T0) and after (T1) engaging in a negative emotion induction task. Subsequently, participants completed an ER strategy task based on their assigned ER strategy condition and completed a third state assessment (T2). RESULTS Time had a significant quadratic effect on alcohol craving, such that craving increased from T0 to T1 and decreased from T1 to T2. There was no significant effect of ER strategy condition on craving. Change in S-DER mediated the relationship between the change in negative/positive emotion and the change in craving, with emotional modulation and emotional acceptance facets of S-DER dominating the mediating effect during negative emotion induction and ER strategy induction, respectively. CONCLUSIONS Results suggest interventions targeting S-DER's emotional modulation and acceptance facets could reduce acute craving when experiencing undesired emotions.
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9
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Marti-Prats L, Belin D. Characterization in the rat of the individual tendency to rely on alcohol to cope with distress and the ensuing vulnerability to drink compulsively. Brain Commun 2024; 6:fcae169. [PMID: 38868300 PMCID: PMC11168338 DOI: 10.1093/braincomms/fcae169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/12/2024] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
Only some vulnerable individuals who recreationally drink alcohol eventually develop the compulsive drinking pattern that characterizes alcohol use disorder. A new frontier in biomedical research lies in understanding the neurobehavioural mechanisms of this individual vulnerability, a necessary step towards developing novel effective therapeutic strategies. Translational research has been hindered by the lack of valid, reliable and robust approaches that enable the study of the influence of the reliance on alcohol to cope with stress or self-medicate negative emotional states on the subsequent transition to alcohol use disorder. We have therefore developed a behavioural task in the rat that enables the investigation of the neural and cellular basis of the exacerbation of the vulnerability to develop compulsive alcohol drinking by the use of alcohol to develop an adjunctive, anxiolytic, polydipsic drinking behaviour in a schedule-induced polydipsia procedure. Hence, in our task, alcohol is introduced in the schedule-induced polydipsia context after several weeks of training with water so that rats are exposed to alcohol for the first time in a distressing context and learn to drink alcohol as a coping strategy. Capitalizing on this protocol, we have consistently been able to identify a subpopulation of rats that were unable to learn to cope with negative states by drinking water and relied on alcohol to do so. This maladaptive reliance on alcohol drinking to cope with distress has been shown to be associated with an exacerbation of the subsequent transition to compulsive drinking. Furthermore, these vulnerable rats reached blood alcohol levels comparable to that of intoxication in humans, thereby developing two key features of alcohol use disorder, namely excessive alcohol intake and compulsive drinking. Altogether, this behavioural task provides a novel and unique tool for the investigation of the neurobehavioural mechanisms underlying the exacerbation of the individual vulnerability to developing compulsive alcohol drinking by the use of alcohol as a strategy to cope with distress, and for the evaluation of the efficacy of potential therapeutic strategies in a personalized medicine approach. This procedure, which focuses on an understudied but key factor of the development of alcohol use disorder, may become widely used as it benefits the fields of alcohol, emotion regulation and stress, the interest in which has substantially increased since the evidence of a profound exacerbation of alcohol use and alcohol-related negative consequences by the distress and social isolation engendered by the various measures implemented worldwide in response to the COVID-19 pandemic.
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Affiliation(s)
- Lucia Marti-Prats
- Department of Psychology, CLIC (Cambridge Laboratory for Research on Impulsive/Compulsive Disorders), University of Cambridge, Cambridge CB2 3EB, UK
| | - David Belin
- Department of Psychology, CLIC (Cambridge Laboratory for Research on Impulsive/Compulsive Disorders), University of Cambridge, Cambridge CB2 3EB, UK
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Palazón-Llecha A, Caparrós B, Trujols J, Duran-Sindreu S, Batlle F, Madre M, Mallorquí-Bagué N. Predictors of cocaine use disorder treatment outcomes: a systematic review. Syst Rev 2024; 13:124. [PMID: 38720357 PMCID: PMC11077740 DOI: 10.1186/s13643-024-02550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 04/26/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Psychosocial approaches are the first-line treatments for cocaine dependence, although they still present high dropout and relapse rates. Thus, there is a pressing need to understand which variables influence treatment outcomes to improve current treatments and prevent dropout and relapse rates. The aim of this study is to explore predictors of treatment retention and abstinence in CUD. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched three databases-PubMed, PsychINFO and Web of Science-for randomized clinical trials (RCTs) published in English and Spanish from database inception through April 1, 2023. We selected all studies that met the inclusion criteria (adults aged ≥ 18, outpatient treatment, CUD as main addiction, and no severe mental illness) to obtain data for the narrative synthesis addressing cocaine abstinence and treatment retention as main outcome variables. After data extraction was completed, risk of bias was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB-2). RESULTS A total of 566 studies were screened, and, of those, 32 RCTs were included in the synthesis. Younger age, more years of cocaine use, and craving levels were significant predictors of relapse and treatment dropout. Fewer withdrawal symptoms, greater baseline abstinence, greater treatment engagement, and more self-efficacy were all predictors of longer duration of abstinence. The role of impulsivity as a predictor of CUD is unclear due to conflicting data, although the evidence generally suggests that higher impulsivity scores can predict more severe addiction and withdrawal symptoms, and earlier discontinuation of treatment. CONCLUSION Current evidence indicates which variables have a direct influence on treatment outcomes, including well-studied cocaine use-related variables. However, additional variables, such as genetic markers, appear to have a high impact on treatment outcomes and need further study. SYSTEMATIC REVIEW REGISTRATION This systematic review is registered at PROSPERO (ID: CRD42021271847). This study was funded by the Spanish Ministry of Science, Innovation and Universities, Instituto Carlos III (ISCIII) (FIS PI20/00929) and FEDER funds and Fundació Privada Hospital de la Santa Creu i Sant Pau (Pla d'acció social 2020).
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Affiliation(s)
- Alba Palazón-Llecha
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain
- Department of Psychology, University of Girona, Edifici Seminari, Campus Barri Vell, Sant Domènech 9, 17004, Girona, Spain
| | - Beatriz Caparrós
- Department of Psychology, University of Girona, Edifici Seminari, Campus Barri Vell, Sant Domènech 9, 17004, Girona, Spain
| | - Joan Trujols
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 3-5, Pavellón 11, Planta 0, 28029, Madrid, Spain
| | - Santiago Duran-Sindreu
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Monforte de Lemos 3-5, Pavellón 11, Planta 0, 28029, Madrid, Spain
| | - Francesca Batlle
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain
| | - Mercè Madre
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Addictive Behaviours Unit, Hospital de La Santa Creu I Sant Pau, Sant Antoni Maria Claret 167, Pavelló 20, Planta 2, 08025, Barcelona, Spain.
- Mental Health Research Group, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quintí 77-79, 08041, Barcelona, Spain.
- Department of Psychology, University of Girona, Edifici Seminari, Campus Barri Vell, Sant Domènech 9, 17004, Girona, Spain.
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Zvolensky MJ, Clausen BK, Shepherd JM, Redmond BY, Robison JH, Santiago-Torres M, Bricker JB. Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states. Addict Behav 2024; 152:107959. [PMID: 38309241 PMCID: PMC11195297 DOI: 10.1016/j.addbeh.2024.107959] [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: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.
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Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center; HEALTH Institute, University of Houston.
| | | | | | | | | | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences; Department of Psychology, University of Washington
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Di Nicola M, Pepe M, Montanari S, Marcelli I, Panaccione I, Janiri D, Janiri L, Sani G. Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation. CHILD ABUSE & NEGLECT 2024; 151:106731. [PMID: 38507922 DOI: 10.1016/j.chiabu.2024.106731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Suicide attempts (SA) are a public health concern because of increasing prevalence and clinical implications. Childhood trauma (CT) and emotion dysregulation (ED) have been proposed as predictors of SA, but few data are available in patients with Substance Use Disorder (SUD). OBJECTIVE Our study aims to investigate the association of sociodemographic/clinical variables, CT typologies, and ED features with SA in SUD patients. PARTICIPANTS AND SETTING Subjects with SUD were screened in an outpatient setting. The final sample consisted of 226 patients, subdivided according to the presence of lifetime SA (SUD, n = 163 vs. SUD-SA, n = 63). METHODS Participants were compared for sociodemographic and clinical information. CT and ED were assessed through the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS), respectively. We performed a mediation analysis to test the effect of CT and ED on SA. RESULTS Patients with a history of SA (27.9 %) displayed more psychiatric comorbidities (p = 0.002) and hospitalizations (p < 0.001), higher scores at CTQ-SF sexual abuse (p < 0.001) and DERS 'impulse' (p = 0.002), 'goals', 'non-acceptance', 'strategies' (p < 0.001) subscales. The relationship between CTQ-SF sexual abuse and SA was significantly mediated by DERS 'strategies' (p = 0.04; bootstrapped 95 % LLCI-ULCI = 0.004-0.024). CONCLUSIONS CT and different dimensions of ED were associated with SA in SUD patients. In our sample, the effects of childhood sexual abuse on SA were mediated by limited access to emotion regulation strategies. SUD patients are burdened with higher all-cause mortality, and CT and lifetime SA can worsen clinical outcomes. Clarifying the reciprocal interactions of psychopathological dimensions may help deliver targeted interventions and reduce suicide risk in specific populations.
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Affiliation(s)
- Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy.
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Ilaria Marcelli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | | | - Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
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13
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Waite EE, Raudales AM, Newberger NG, Ferguson JJ, Denning DM, Huffman S, Weiss NH, Dixon-Gordon KL. Longitudinal examination of borderline personality disorder symptoms and drug use: The influence of negative and positive emotion dysregulation. Personal Ment Health 2024; 18:157-165. [PMID: 38378990 PMCID: PMC11068492 DOI: 10.1002/pmh.1602] [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: 08/23/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 02/22/2024]
Abstract
Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1 year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.
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Affiliation(s)
- Elinor E. Waite
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Alexa M. Raudales
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | - Noam G. Newberger
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | | | - Dominic M. Denning
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Sarah Huffman
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | - Katherine L. Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
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Nilsson AH, Schwartz HA, Rosenthal RN, McKay JR, Vu H, Cho YM, Mahwish S, Ganesan AV, Ungar L. Language-based EMA assessments help understand problematic alcohol consumption. PLoS One 2024; 19:e0298300. [PMID: 38446796 PMCID: PMC10917301 DOI: 10.1371/journal.pone.0298300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Unhealthy alcohol consumption is a severe public health problem. But low to moderate alcohol consumption is associated with high subjective well-being, possibly because alcohol is commonly consumed socially together with friends, who often are important for subjective well-being. Disentangling the health and social complexities of alcohol behavior has been difficult using traditional rating scales with cross-section designs. We aim to better understand these complexities by examining individuals' everyday affective subjective well-being language, in addition to rating scales, and via both between- and within-person designs across multiple weeks. METHOD We used daily language and ecological momentary assessment on 908 US restaurant workers (12692 days) over two-week intervals. Participants were asked up to three times a day to "describe your current feelings", rate their emotions, and report their alcohol behavior in the past 24 hours, including if they were drinking alone or with others. RESULTS Both between and within individuals, language-based subjective well-being predicted alcohol behavior more accurately than corresponding rating scales. Individuals self-reported being happier on days when drinking more, with language characteristic of these days predominantly describing socializing with friends. Between individuals (over several weeks), subjective well-being correlated much more negatively with drinking alone (r = -.29) than it did with total drinking (r = -.10). Aligned with this, people who drank more alone generally described their feelings as sad, stressed and anxious and drinking alone days related to nervous and annoyed language as well as a lower reported subjective well-being. CONCLUSIONS Individuals' daily subjective well-being, as measured via language, in part, explained the social aspects of alcohol drinking. Further, being alone explained this relationship, such that drinking alone was associated with lower subjective well-being.
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Affiliation(s)
- August Håkan Nilsson
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Oslo Business School, Oslo Metropolitan University, Oslo, Norway
| | - Hansen Andrew Schwartz
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Richard N. Rosenthal
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States of America
| | - James R. McKay
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Huy Vu
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Young-Min Cho
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Syeda Mahwish
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Adithya V. Ganesan
- Department of Computer Science, Stony Brook University, Stony Brook, New York, United States of America
| | - Lyle Ungar
- Department of Computer and Information Science, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
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15
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Schettler LM, Thomasius R, Paschke K. Emotional dysregulation predicts problematic gaming in children and youths: a cross-sectional and longitudinal approach. Eur Child Adolesc Psychiatry 2024; 33:605-616. [PMID: 36932230 PMCID: PMC10023309 DOI: 10.1007/s00787-023-02184-x] [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: 07/12/2022] [Accepted: 02/27/2023] [Indexed: 03/19/2023]
Abstract
Adolescents show a high vulnerability for addictive gaming patterns on the one hand and immature emotion regulation (ER) abilities as a risk factor for mental disorders on the other hand. We investigated the predictive value of ER difficulties on problematic gaming (PG) considering age groups (children vs. youths) and gender cross-sectionally and prospectively in a representative sample of German adolescents via online survey with two measurement points 14 months apart. General Poisson, logistic, and multinomial regression models were estimated to predict gaming patterns by ER difficulties controlling for age group and gender. Results revealed ER difficulties to be significantly associated with PG. Moreover, subgroup analyses indicated differing ER patterns for children vs. youths and boys vs. girls: for children, higher PG values were associated with emotional awareness and emotional clarity whereas for youths it was the acceptance of emotional responses. Moreover, gender differences implicated that boys with PG had more deficits in goal-oriented behavior as well as emotional awareness while affected girls were lacking emotional clarity and had problems with the acceptance of their emotional responses. Interestingly, procrastination was a significant predictor for PG irrespective of subgroups. Furthermore, longitudinal analyses indicated that difficulties in ER promoted PG while stronger procrastination tendencies maintained it. With the inclusion of procrastination, which can be understood as a maladaptive ER strategy, a broader picture of ER difficulties as a risk factor for PG could be drawn. The findings support a better understanding of PG etiology and the development of targeted prevention and intervention measures.
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Affiliation(s)
- Leonie Marie Schettler
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Rainer Thomasius
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Kerstin Paschke
- German Center for Addiction Research in Childhood and Adolescence (DZSKJ), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
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16
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Kiefer R, Thomas ED, Lawrence ER, Goldstein. SC, Dixon-Gordon KL, Weiss NH. An investigation of laboratory-based positive and negative emotional suppression in relation to posttraumatic stress disorder symptom clusters. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024:2024-48840-001. [PMID: 38300574 PMCID: PMC11291717 DOI: 10.1037/tra0001644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Emotional suppression is a clinically significant aspect of emotion regulation with robust associations to psychopathology, including posttraumatic stress disorder (PTSD). Despite the fast-growing body of literature highlighting the role of positive emotion regulation difficulties in the development and maintenance of PTSD, extant work on emotional suppression and PTSD has almost exclusively focused on the role of negative emotions. OBJECTIVE The present study aimed to advance this literature by examining the associations between PTSD symptom clusters and participants' use of state emotional suppression during a laboratory task designed to elicit negative or positive emotions. METHOD Participants were 108 community women (Mage = 39.55; 33% Black/African American) currently experiencing intimate partner violence (IPV) by a male partner and using substances. Participants were interviewed using a structured diagnostic assessment for PTSD and reported on state emotional intensity and emotional suppression following idiographic negative or positive emotion inductions. RESULTS Results of the moderation analyses showed that, when controlling for state emotional intensity, women experiencing clinical levels of PTSD symptom Clusters B (intrusive recollections), D (negative alterations in cognitions and mood), and E (alterations in arousal and reactivity) were significantly more likely to utilize emotional suppression, but only in the context of positive-not negative-emotions. CONCLUSIONS Findings provide evidence for a link between PTSD and positive emotional suppression among women currently experiencing IPV by a male partner and using substances, highlighting positive emotional suppression as a potential target in PTSD treatment for IPV populations with comorbid substance use concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Reina Kiefer
- University of Rhode Island, Kingston, Rhode Island, USA
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17
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Hasani J, Emadi Chashmi SJ, Zakiniaeiz Y, Potenza MN. Psychometric properties of the Persian version of the cognitive emotion regulation questionnaire-short (CERQ-P-short): Reliability, validity, factor structure, treatment sensitivity, and measurement invariance. J Psychiatr Res 2024; 170:1-10. [PMID: 38096672 PMCID: PMC11131131 DOI: 10.1016/j.jpsychires.2023.11.011] [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: 02/23/2023] [Revised: 10/26/2023] [Accepted: 11/15/2023] [Indexed: 02/02/2024]
Abstract
AIMS This study aimed to examine the psychometric properties of a widely-used measure of emotion regulation, the short version of the Cognitive Emotion Regulation Questionnaire (CERQ-short), in the Persian language (CERQ-P-short) among Iranian populations. METHODS The CERQ-P-short was administered to 1825 participants (female = 974) including 436 adolescents, 834 adults from the general population, 45 patients each with generalized anxiety and obsessive-compulsive disorders, an additional 30 patients each with generalized anxiety and obsessive-compulsive disorders receiving treatment, 45 patients with substance use disorders (SUDs) and an additional 360 adult psychiatric patients. We tested reliability, factor structure, measurement invariance, convergent and discriminant validity, and treatment sensitivity (i.e., intervention response) by age, sex, and diagnostic group. The Depression Anxiety Stress Scale-21 was also administered. RESULTS Cronbach's alpha coefficient and test-retest coefficients suggested good reliability. Fit indices suggested that the 9-factor CERQ-P-Short model was good across groups. The CERQ-P-Short showed good measurement invariance in all four models (configural, metric, scalar, and strict) in all groups. Both adaptive and maladaptive cognitive emotion-regulation strategies demonstrated convergent and discriminant validity. Finally, treatment sensitivity of the CERQ-P-Short scale before and after the completion of treatment sessions was suggested for patients with generalized anxiety and obsessive-compulsive disorders. CONCLUSIONS While the present study has some limitations, it represents a significant contribution because it supports CERQ-P-Short scales usefulness, validity, and reliability in the general population and among psychiatric patients. The results of the current study can be beneficial to the both clinicians and researchers.
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Affiliation(s)
- Jafar Hasani
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran.
| | | | - Yasmin Zakiniaeiz
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marc N Potenza
- Departments of Psychiatry and Neuroscience, The Child Study Center and the Wu Tsai Institute, Yale University and Yale University School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA
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18
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Loreto BBL, Sordi AO, de Castro MN, Ornell F, Guarnieri EP, Roza TH, Schuch JB, Cima MDS, Pechansky F, Grevet EH, Grassi-Oliveira R, von Diemen L, Kessler FHP. Proposing an integrative, dynamic and transdiagnostic model for addictions: dysregulation phenomena of the three main modes of the predostatic mind. Front Psychiatry 2024; 14:1298002. [PMID: 38274436 PMCID: PMC10808830 DOI: 10.3389/fpsyt.2023.1298002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/28/2023] [Indexed: 01/27/2024] Open
Abstract
Several theories have been proposed to explain the complex diagnostic aspects related to addiction disorders and their development. Recent frameworks tend to focus on dimensional perspectives of symptoms rather than categorical systems, since substance use disorders are frequently comorbid with other psychiatric and especially personality disorders. However, useful transdiagnostic models that could integrate clinical evaluation derived from neuroscientific theories are lacking. In the present manuscript, the authors propose a model based on a new paradigm, in an attempt to better explain this complex, multifaceted phenomenon. The new paradigm presupposes that emotions and behavior are a response to risk prediction. Individuals make choices and engage in actions to manage potential risks/rewards in order to seek or maintain homeostasis in their internal and external environments - a mechanism that the authors call predostatic (predictive mechanism with homeostatic purpose). The model considers three main modes of the predostatic mind: (1) Alarm Mode, activated by high and/or imminent risk prediction; (2) Seek Mode, activated by long-term risk or reward prediction; and (3) Balance Mode, a self-regulating state of mind related to low risk prediction, a soothing system and a calm state. Addiction is seen as a chronic dysregulation of organism systems leading to internalizing or externalizing phenomena mainly related to the Seek and Alarm Modes, which are persistently activated by reward and risk prediction, respectively, thus hindering Balance. Addiction neuroscience research has shown that chronic drug use or engagement in addictive behaviors can lead to neuroadaptations in the brain reward circuitry, disrupting normal balance and the regulation of reward processes. This dysregulation can contribute to persistent drug-seeking/addictive behaviors despite negative consequences. This newly proposed dynamic and integrative model, named dysregulation based on externalizing and internalizing phenomena of the three main modes of the predostatic mind (DREXI3), proposes six dysregulation dimensions with basic emotional and behavioral symptoms, such as neurophysiological alterations, impulsivity, compulsion, cognitive impairment/psychosis, mood, and anxiety/anger. In this paper, the authors explain the rationale behind DREXI3 and present some hypothetical clinical examples to better illustrate the use of the model in clinical practice. The development of this innovative model could possibly guide tailored treatment interventions in the addiction field.
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Affiliation(s)
- Bibiana Bolten Lucion Loreto
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anne Orgler Sordi
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Melina Nogueira de Castro
- Addiction and Forensic Psychiatry Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Felipe Ornell
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eduardo Pegoraro Guarnieri
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | - Jaqueline Bohrer Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marcos da Silveira Cima
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Pechansky
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Eugênio Horácio Grevet
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Department of Clinical Medicine, Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Lisia von Diemen
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Waite EE, DeFontes C, Weiss NH, Karnedy C, Woods SE, Haliczer LA, Dixon-Gordon KL. Borderline personality disorder and multidimensional impulsivity: The roles of positive and negative emotion dysregulation. J Affect Disord 2024; 344:635-643. [PMID: 37832740 DOI: 10.1016/j.jad.2023.10.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Risky, self-destructive impulsivity and emotion dysregulation are core features of borderline personality disorder (BPD). Yet impulsivity is multidimensional and has rarely been comprehensively assessed in BPD. Impulsivity has been linked to negative emotion dysregulation, yet explorations of the role of positive emotion dysregulation have been neglected. The current study attempts to extend existing literature by identifying the pattern of associations of specific domains of impulsivity, using both self-report and behavioral measures in BPD, and the role of both negative and positive emotion dysregulation in this link. METHODS Adults with BPD (n = 48), subthreshold BPD (n = 37), and without BPD (n = 78) completed a diagnostic interview, self-report measures, and multiple behavioral tasks. We examined correlations between primary variables, then examined the role of negative and positive emotion dysregulation in the association between BPD and specific domains of impulsivity. RESULTS Negative emotion dysregulation accounted for the link between BPD and negative urgency, (lack of) premeditation, and (lack of) perseverance, while positive emotion dysregulation accounted for the relation between BPD and sensation seeking. LIMITATIONS Key limitations of this study include using a relatively homogeneous sample and using abbreviated versions of one behavioral task, among others discussed. CONCLUSIONS These findings locate the precise impulsivity impairments in BPD and highlight the differential roles of negative and positive emotion dysregulation. Understanding the impulsivity deficits associated with BPD will further explain the impulsive behaviors associated with this disorder, and the contexts in which they occur, which may streamline clinical treatments.
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Affiliation(s)
- Elinor E Waite
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Clara DeFontes
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Nicole H Weiss
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States; Department of Psychology, University of Rhode Island, United States
| | - Colten Karnedy
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Sherry E Woods
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Lauren A Haliczer
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States
| | - Katherine L Dixon-Gordon
- Department of Psychological and Brain Science, University of Massachusetts Amherst, United States.
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Chen SJ, Lu MY, Lai JCY, Bair MJ, Cheng HY. Sex and age disparities in the influence of tobacco smoking on depression: Evidence from the Taiwan Biobank. Tob Induc Dis 2023; 21:155. [PMID: 38026502 PMCID: PMC10668579 DOI: 10.18332/tid/174643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION The global tobacco epidemic poses a notable challenge to global health due to its association with various tobacco-related diseases. Although tobacco smoking is associated with depression, the exact mechanism by which tobacco smoking increases the risk of depression is unclear. This study explored the potential effects of tobacco smoking on depression. METHODS We used data in the analysis from the Taiwan Biobank of 27916 individuals recruited from 2015 to 2020. To investigate the associations between tobacco use and depression, the results of the depression-measuring subscale of the Patient Health Questionnaire-4 as well as data on participants' tobacco consumption and other relevant covariates, were analyzed. RESULTS Participants who smoked were more likely to report depression than those who did not smoke (AOR=1.50; 95% CI: 1.21-1.86). Furthermore, depression was significantly higher in women who smoked than in their male counterparts (females: AOR=1.68; 95% CI: 1.27-2.23, and males: AOR=1.32; 95% CI: 0.96-1.80). Women aged <55 years and who smoked were more likely to report depression, whereas this trend was not observed in those aged ≥55 years (<55 years: AOR=1.75; 95% CI: 1.23-2.48), and ≥55 years: AOR=1.58; 95% CI: 0.97-2.56). CONCLUSIONS Tobacco smoking is a significant factor associated with depression, particularly in younger women. The increasing prevalence of tobacco use for years among younger women in Taiwan might contribute to shifts in the associations between depression and tobacco use in women.
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Affiliation(s)
- Shaw-Ji Chen
- Department of Psychiatry, MacKay Memorial Hospital, Taitung, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- National Taitung University, Taitung, Taiwan
| | - Meng-Ying Lu
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung, Taiwan
| | - Jerry Cheng-Yen Lai
- National Taitung University, Taitung, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taitung, Taiwan
| | - Ming-Jong Bair
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taitung, Taiwan
| | - Hsiao-Yang Cheng
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taitung, Taiwan
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21
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Lin S, Tan L, Chen X, Liao Z, Li Y, Tang Y, Shi Y, Hao J, Wang X, Huang Q, Shen H. Emotion dysregulation and Internet gaming disorder in young people: Mediating effects of negative affect and metacognitions. J Affect Disord 2023; 341:104-111. [PMID: 37597784 DOI: 10.1016/j.jad.2023.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Recent studies have found that emotion dysregulation, negative affect, and metacognitions about online gaming are risk factors for Internet gaming disorder (IGD). However, few studies investigated the mechanisms underlying these interactions. The present study aimed to explore the relationships between emotion dysregulation and IGD, and the mediating effects of negative affect and metacognitions about online gaming. METHODS An online survey was conducted with young people (aged 10-24 years) who played video games. 1768 participants were included in this study. Observed variables, including emotion dysregulation, IGD, depression, anxiety, and metacognitions, were measured with self-report scales. Structural equation modeling (SEM) was used to analyze the relationships among the variables. RESULTS The results showed that emotion dysregulation positively predicted IGD through a fully mediated model which included the independent mediating effects of negative affect and metacognitions about online gaming and their sequential mediating effect. The model explained 76.1 % of the variance in IGD. LIMITATIONS This was a cross-sectional study which could not infer causality. CONCLUSIONS This study emphasizes that negative affect and metacognitions about online gaming mediate the effect of emotion dysregulation on IGD; moreover, metacognition may be a proximal factor of IGD. Thus, improving emotional regulation and modifying maladaptive metacognitions in young people may improve the prevention and treatment of IGD.
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Affiliation(s)
- Shuhong Lin
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Linxiang Tan
- School of Marxism, Central South University, Changsha, China
| | - Xinxin Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Zhenjiang Liao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yifan Li
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Ying Tang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Yongyan Shi
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Jingyue Hao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Xuhao Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China
| | - Qiuping Huang
- Department of Psychology, School of Humanities and Management, Hunan University of Chinese Medicine, Changsha, Hunan, China.
| | - Hongxian Shen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China; Institute of Mental Health of Central South University, Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Hunan Medical Center for Mental Health, Changsha, Hunan, China.
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22
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Bhuptani PH, Orchowski LM, Forkus SR, Newberger NG, Weiss NH. The impact of exposure to physical and sexual violence on opioid consequences among trauma-exposed individuals recruited from the community who use opioids. Harm Reduct J 2023; 20:167. [PMID: 37950215 PMCID: PMC10638719 DOI: 10.1186/s12954-023-00901-y] [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: 03/08/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023] Open
Abstract
Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the USA. The current study evaluated the consequences associated with opioid use (e.g., physical, social, interpersonal, intrapersonal, and impulse control) as a function of a history of exposure to interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of exposure to sexual violence in the context of opioid use disorder treatment.
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Affiliation(s)
- Prachi H Bhuptani
- Department of Adult Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA
| | - Lindsay M Orchowski
- Department of Adult Psychiatry, Rhode Island Hospital, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Brown University Medical School, Providence, RI, USA
| | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, 142 Flagg Rd., Kingston, RI, USA
- Medical University of South Carolina, Charleston, SC, USA
| | - Noam G Newberger
- Department of Psychology, University of Rhode Island, 142 Flagg Rd., Kingston, RI, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, 142 Flagg Rd., Kingston, RI, USA.
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23
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Moskal KR, Teeters JB, McCollum DC. Examining Differences in Emotion Dysregulation Between Emerging Adult Alcohol-Only Users, Abstainers, and Simultaneous Users. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:34-48. [PMID: 38035171 PMCID: PMC10683745 DOI: 10.26828/cannabis/2023/000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Objective Simultaneous use of alcohol and cannabis is associated with more negative consequences than use of either substance alone. Research suggests that emotion dysregulation is linked to alcohol, cannabis, and polysubstance use. However, no previous research has examined whether emotion dysregulation scores differ among individuals without past month substance use (abstainers), individuals who report past-month alcohol use only (no past month cannabis or simultaneous use; alcohol-only users), and individuals who engage in past-month simultaneous alcohol and cannabis use (simultaneous users). Our aim was to examine differences in overall levels of emotion dysregulation and emotion dysregulation subscales between these groups. Methods The sample included 468 college students. Participants completed an online survey assessing demographics, emotion dysregulation, average number of drinks per week, days of monthly cannabis use, and simultaneous use of alcohol and cannabis. Results A one-way ANOVA showed significant differences in emotion dysregulation between alcohol-only users, abstainers, and simultaneous users. A Bonferroni post hoc analysis revealed significant differences in emotion dysregulation for simultaneous users (p = .004) compared to alcohol-only users and abstainers. A series of ANOVAs were run to examine emotion dysregulation subscale scores and significant differences were found for impulse control difficulties (p = .003) and limited access to emotion regulation strategies (p = .005) for simultaneous users compared to alcohol-only users and abstainers, and for non-acceptance of emotional responses (p = .018) for simultaneous users compared to and alcohol-only users. Conclusion These findings indicate that simultaneous users have higher levels of emotion dysregulation, higher levels of impulse control difficulties, greater non-acceptance of emotions, and greater lack of access to emotion regulation strategies compared to abstainers and alcohol-only users.
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Affiliation(s)
- Katie R. Moskal
- Department of Psychological Sciences, Western Kentucky University
| | - Jenni B. Teeters
- Department of Psychological Sciences, Western Kentucky University
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24
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Zvolensky MJ, Shepherd JM, Clausen BK, Garey L, Kauffman BY, Brown RA, Bogiaizian D, Salazar PL, Viana AG. Anxiety-related constructs and smoking outcome expectancies among Latinx smokers. Exp Clin Psychopharmacol 2023; 31:942-952. [PMID: 36480393 PMCID: PMC10247902 DOI: 10.1037/pha0000625] [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: 12/14/2022]
Abstract
Hispanic/Latinx (hereafter Latinx) smokers in the United States (US) experience unique smoking cessation-related challenges. Smoking outcome expectancies (i.e., positive and negative beliefs about the consequences of smoking behavior) have been linked to the maintenance of smoking and comorbidity with negative emotional states such as anxiety among Latinx smokers. However, past work has not characterized rates of probable anxiety disorder and elevated levels of anxiety sensitivity among English-speaking daily Latinx smokers from the United States or concurrently evaluated the explanatory relevance of anxiety symptoms and anxiety sensitivity for negative and positive smoking outcome expectancies. The present investigation sought to (a) determine the base rate of probable anxiety disorder and elevated anxiety sensitivity and (b) explore the unique roles of anxiety symptoms and anxiety sensitivity in relation to negative and positive smoking outcome expectancies. Participants included 338 English-speaking Latinx adult daily cigarette smokers from the United States (Mage = 35.53 years; SD = 8.65; age range 18-61; 37.3% female). Findings revealed high rates of probable anxiety disorder (50.9%) and elevated anxiety sensitivity (73.4%) among English-speaking Latinx smokers from the United States. Anxiety sensitivity, but not anxiety symptoms or disorders, was significantly related to negative consequences, negative reinforcement, positive reinforcement, and appetite/weight control smoking outcome expectancies. Overall, anxiety experiences were common among Latinx smokers, and anxiety sensitivity was a relatively more consistent and robust predictor of negative and positive outcome expectancies relative to anxiety symptoms and probable anxiety disorder. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
- HEALTH Institute, University of Houston
| | | | | | - Lorra Garey
- Department of Psychology, University of Houston
| | | | - Richard A. Brown
- Health Behavior Solutions, Austin, TX, USA
- Department of Psychology and School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Daniel Bogiaizian
- Psychotherapeutic Area of “Asociación Ayuda”, Anxiety Disorders Clinic (Buenos Aires, Argentina)
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
| | - Patricio López Salazar
- Psychotherapeutic Area of “Asociación Ayuda”, Anxiety Disorders Clinic (Buenos Aires, Argentina)
- Department of Psychology, Universidad Argentina de la Empresa, Buenos Aires, Argentina
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25
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Weiss NH, Goncharenko S, Forkus SR, Ferguson JJ, Yang M. Longitudinal Investigation of Bidirectional Relations Between Childhood Trauma and Emotion-Driven Impulsivity in the Adolescent Brain Cognitive Development Study. J Adolesc Health 2023; 73:731-738. [PMID: 37410001 PMCID: PMC10529354 DOI: 10.1016/j.jadohealth.2023.05.027] [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: 10/19/2022] [Revised: 05/01/2023] [Accepted: 05/27/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Exposure to childhood trauma is associated with numerous adverse mental health consequences. Addressing important gaps in the existing research, the proposed study clarifies the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. METHOD This study utilized a sample of 11,872 9- to 10-years-olds recruited from 21 research sites across the United States from the Adolescent Brain Cognitive Ddevelopment (ABCD) Study. Childhood trauma was assessed at one- and two-year follow-ups. Negative and positive urgency were assessed at baseline and two-year follow-up. Cross-lagged panel models evaluated the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. RESULTS Findings showed that earlier childhood trauma was associated with higher levels of later negative (β = 0.133, p < .001) and positive (β = 0.125, p < .001) emotion-driven impulsivity. Further, higher levels of earlier positive (β = 0.033, p < .006), but not negative (β = 0.010, p = .405), emotion-driven impulsivity were associated with later childhood trauma. Finally, the strength of the relations between childhood trauma and emotion-driven impulsivity did not differ by sex (ΔX2 = 10.228, p > .05). DISCUSSION Identification of both negative and positive emotion-driven impulsivity among children exposed to trauma may serve as a point of intervention to reduce subsequent risk for deleterious health outcomes.
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Affiliation(s)
- Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island.
| | | | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island; Medical University of South Carolina, Charleston, South Carolina
| | - Jewelia J Ferguson
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
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26
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Pilkington PD, Karantzas GC, Faustino B, Pizarro-Campagna E. Early maladaptive schemas, emotion regulation difficulties and alexithymia: A systematic review and meta-analysis. Clin Psychol Psychother 2023. [PMID: 37735142 DOI: 10.1002/cpp.2914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Emotion regulation is an integral part of the schema therapy model. The aim of this systematic review and meta-analysis was to synthesize the evidence on the associations between early maladaptive schemas (EMSs), difficulties with emotion regulation and alexithymia. METHOD PsycINFO, PubMed and CINAHL Complete databases were searched on 28 May 2022 and 3 February 2023 in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Included studies were in English, in peer-reviewed journals and reported on the association between one or more of the 18 EMSs or five schema domains and emotion regulation difficulties or alexithymia. Methodological quality was assessed using the Appraisal Tool for Cross-Sectional Studies. Meta-analyses were conducted to examine difficulties with emotion regulation and alexithymia as correlates of each EMS and domain. RESULTS A total of 19 studies published between 2008 and 2022 were included (Pooled N = 5957). Difficulties with emotion regulation were positively correlated with all 18 EMSs (range: entitlement r(7) = .28, 95% CI [.13, .42] to negativity pessimism r(5) = .53, 95% CI [.23, .74]) and schema domains (range: impaired limits r(5) = .34, 95% CI [.08, .56] to disconnection rejection r(5) = .44, 95% CI [.33, .73]). Alexithymia was positively correlated with the other-directedness domain (r(2) = .40, 95% CI [.09, .64]) and 16 of the 18 EMSs (range: unrelenting standards r(5) = .21, 95% CI [.12, .28] to emotional inhibition r(5) = .50, 95% CI [.34, .63]). CONCLUSIONS The findings suggested that almost all 18 EMSs are implicated in emotion regulation difficulties and alexithymia, particularly those relating to unmet needs for attachment and autonomy.
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Affiliation(s)
- Pamela D Pilkington
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Gery C Karantzas
- School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Bruno Faustino
- HEI-Lab, Lusófona University, Lisbon, Portugal
- Faculdade de Psicologia da Universidade de Lisboa, Lisbon, Portugal
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27
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Morawetz C, Berboth S, Chirokoff V, Chanraud S, Misdrahi D, Serre F, Auriacombe M, Fatseas M, Swendsen J. Mood Variability, Craving, and Substance Use Disorders: From Intrinsic Brain Network Connectivity to Daily Life Experience. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:940-955. [PMID: 36775712 DOI: 10.1016/j.bpsc.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/13/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are major contributors to morbidity and mortality rates worldwide, and this global burden is attributable in large part to the chronic nature of these conditions. Increased mood variability might represent a form of emotional dysregulation that may have particular significance for the risk of relapse in SUD, independent of mood severity or diagnostic status. However, the neural biomarkers that underlie mood variability remain poorly understood. METHODS Ecological momentary assessment was used to assess mood variability, craving, and substance use in real time in 54 patients treated for addiction to alcohol, cannabis, or nicotine and 30 healthy control subjects. Such data were jointly examined relative to spectral dynamic causal modeling of effective brain connectivity within 4 networks involved in emotion generation and regulation. RESULTS Differences in effective connectivity were related to daily life variability of emotional states experienced by persons with SUD, and mood variability was associated with craving intensity. Relative to the control participants, effective connectivity was decreased for patients in the prefrontal control networks and increased in the emotion generation networks. Findings revealed that effective connectivity within the patient group was modulated by mood variability. CONCLUSIONS The intrinsic causal dynamics in large-scale neural networks underlying emotion regulation play a predictive role in a patient's susceptibility to experiencing mood variability (and, subsequently, craving) in daily life. The findings represent an important step toward informing interventional research through biomarkers of factors that increase the risk of relapse in persons with SUD.
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Affiliation(s)
- Carmen Morawetz
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
| | - Stella Berboth
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Valentine Chirokoff
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
| | - Sandra Chanraud
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fuschia Serre
- Centre National de la Recherche Scientifique UMR 6033 - Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- Centre National de la Recherche Scientifique UMR 6033 - Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France; Centre Hospitalier Charles Perrens, Bordeaux, France; Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Melina Fatseas
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Joel Swendsen
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
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28
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Aurora P, LoSavio ST, Kimbrel NA, Beckham JC, Calhoun PS, Dillon KH. Examining the daily relationship between guilt, shame, and substance use among veterans with psychiatric disorders. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 8:100174. [PMID: 37753347 PMCID: PMC10518500 DOI: 10.1016/j.dadr.2023.100174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/09/2023] [Accepted: 06/09/2023] [Indexed: 09/28/2023]
Abstract
Background Shame and guilt are key emotions known to amplify trauma-related symptoms in veterans. Maintenance of symptoms is facilitated by avoidance behaviors, such as substance use. However, limited research has examined the associations between shame, guilt, and substance use in daily life. Methods The current study sought to examine the cross-lagged association between shame, guilt, and substance use. Forty veterans completed 28 days of experience sampling reporting on their current emotional experiences and use of substances. Results Results suggest a reciprocal relationship among shame and guilt and substance use, such that shame and guilt separately predicted subsequent substance use, and substance use predicted subsequent shame and guilt. Conclusions These results highlight the dynamic relationship among shame, guilt, and substance use and suggest the potential value of conceptualizing these clinical targets as mutually reinforcing to inform integrative intervention strategies that can interrupt the in-the-moment cascade of negative consequences.
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Affiliation(s)
- Pallavi Aurora
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
| | - Stefanie T. LoSavio
- Durham VA Health Care System, Durham NC, USA
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nathan A. Kimbrel
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Jean C. Beckham
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Patrick S. Calhoun
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Kirsten H. Dillon
- Durham VA Health Care System, Durham NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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29
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Ruyak SL, Roberts MH, Chambers S, Ma X, DiDomenico J, De La Garza R, Bakhireva LN. Impulsivity and Alcohol Use during Pregnancy and Postpartum: Insights from Novel Methodological Approaches within the Context of the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:600. [PMID: 37504047 PMCID: PMC10376597 DOI: 10.3390/bs13070600] [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] [Received: 05/27/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Impaired emotion regulation and impulsivity have been linked to substance use. This study evaluated the association between emotion regulation difficulties-specifically impulsivity-and substance use within the context of the COVID-19 pandemic among pregnant (n = 49) and postpartum (n = 20) women. Participants from a prospective cohort ENRICH-2 completed a baseline phone survey of COVID-19-related experiences and impulsivity followed by a 14-day (3x/day) mobile ecological momentary assessment (mEMA) of impulsivity and substance use. Between-subject (BS) and within-subject (WS) associations for baseline impulsivity and momentary impulsivity with respect to substance use were examined using mixed effects models. At the BS level, momentary impulsivity scores that were higher than the overall group average were positively associated with subsequent momentary reports of marijuana use (β = 1.25; p = 0.04) when controlling for pregnancy status and COVID-19-related stress. At the WS level, momentary impulsivity scores that were higher than an individual's average score were positively associated with subsequent reports of momentary alcohol use (β = 0.08; p = 0.04). This research supports the idea that impulsivity varies based on individual situations, such as stress associated with the COVID-19 pandemic, and may be an important correlate of substance use in pregnant and postpartum women. Future research might consider investigation of additional factors, which may serve to moderate or mediate the relationship between impulsivity and substance use.
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Affiliation(s)
- Sharon L Ruyak
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Stephanie Chambers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Xingya Ma
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Richard De La Garza
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
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Castro-Ramirez F, Paz-Pérez MA, McGuire TC, Rankin O, Alfaro MCG, Audirac AM, Campuzano MLG, Coady P, Núñez-Delgado M, Manana J, Hernández-de la Rosa C, Tambedou T, Vergara GA, Barranco LA, Cudris-Torres L, Nock MK, Naslund JA, Benjet C. A Qualitative Examination of the Impact of Suicidal Thoughts and Behavior on Help-Seeking Among University Students in Colombia and Mexico. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2023; 33:67-80. [PMID: 37680902 PMCID: PMC10482072 DOI: 10.1016/j.jbct.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
This study examined descriptions of suicidal thoughts and behavior (STB) to identify risk and protective factors that may present in clinical settings among university students from Latin America. Our focus was on answering the following key questions: How are suicidal thoughts and behavior described? What are reasons for wanting to die and for living? What impact do STBs have on motivations to seek or avoid psychological treatment? To this end, 55 qualitative interviews were completed with university students from Colombia and Mexico who recently endorsed emotional difficulties in the World Mental Health International College Student (WMH-ICS) surveys. Interviews were coded to identify themes specific to STBs. Findings revealed insight on symptom presentations and consequences of STBs. Participants described uncontrollable somatic symptoms during periods of high suicide risk, which serves as a relevant clinical marker for health providers. An important reason for living was to avoid suffering for family, which was protective against suicide and motivates familial involvement in treatment planning. Participants sought solutions to emotional problems after experiencing STBs, including psychological treatment. Cultural stigma of mental illness induced feelings of shame and burden, which led to avolition, avoidance, and nondisclosure of symptom severity. This study provides insight into the utility of evaluating cultural context in (a) detecting antecedents to STBs frequently reported as somatic symptoms, (b) identifying protective factors against suicide, and (c) recognizing how stigma of mental illness and suicide, shame avoidance, and familism might influence personal motivations to seek or avoid help for emotional distress.
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Affiliation(s)
| | | | | | - Osiris Rankin
- Department of Psychology, Harvard University, United States
| | | | | | | | - Parker Coady
- Department of Psychology, Harvard University, United States
| | | | | | | | - Tida Tambedou
- Department of Psychology, Harvard University, United States
| | | | | | | | - Matthew K Nock
- Department of Psychology, Harvard University, United States
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, United States
| | - Corina Benjet
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, México
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Weidberg S, González-Roz A, Castaño Y, Secades-Villa R. Emotion dysregulation in relation to cannabis use and mental health among young adults. Addict Behav 2023; 144:107757. [PMID: 37224581 DOI: 10.1016/j.addbeh.2023.107757] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Emotion dysregulation (ED) is a transdiagnostic variable that accounts for the onset and maintenance of mental health disorders. The interplay between ED, cannabis use and mental health has not been appraised in the young adult population and whether there are sex-dependent effects has yet to be examined. This study looked at whether ED mediates the association between past-month cannabis use and mental health, while considering sex as a moderator. METHODS 2,762 (64.2% women) undergraduate Spanish students completed an online battery. Among others, they fulfilled the Depression Anxiety Stress Scale-21 (DASS-21) and the Difficulties in Emotion Regulation Scale (DERS-28). A two-way ANOVA assessed the effects of sex and past-month cannabis use on participants' DASS-21 scores. A set of moderated mediations tested whether the indirect effect of past-month cannabis use on DASS-21 through DERS differed by sex. RESULTS Past-month cannabis female users showed higher levels of depression, anxiety and stress (M = 51.10, SD = 26.72) than did men [(M = 33.76, SD = 20.31); F(1, 2758) = 5.119, p =.024, η2p =.002]. In female young adults only, the effect of past-month cannabis use on mental health was mediated by ED (total score), non-acceptance of emotional responses, lack of emotional control, difficulties in engaging in goal-directed behavior, and lack of emotional clarity (all p's < 0.005) CONCLUSIONS: Findings indicate the importance of considering ED in assessment and intervention practices. Interventions targeting ED may be particularly effective for female young adult cannabis users.
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Affiliation(s)
- Sara Weidberg
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
| | - Alba González-Roz
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain.
| | - Yasmina Castaño
- Department of Psychology. University of the Balearic Islands. Ctra. Valldemossa, km 7.5, 07122, Palma, Spain
| | - Roberto Secades-Villa
- Department of Psychology. Addictive Behaviors Research Group (GCA), University of Oviedo. Plaza Feijoo s/n, 33003, Oviedo, Spain
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Weiss NH, Schick MR, Raudales AM, Forkus SR, Thomas ED, Contractor AA, Sullivan TP. Experimental Investigation of the Influence of Positive Emotion Dysregulation on Risky Behavior Following Idiographic Emotion Inductions. Clin Psychol Sci 2023; 11:490-508. [PMID: 37576546 PMCID: PMC10420898 DOI: 10.1177/21677026221133295] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
An experimental paradigm with subjective and objective assessments was used to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances (Mage = 40.81, 43.0% white). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (versus negative and neutral) emotion induction conditions; and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (versus neutral) emotion induction condition. Findings provide additional support for the influence of positive emotion dysregulation on risky behavior.
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Affiliation(s)
| | - Melissa R. Schick
- University of Rhode Island, Kingston, Rhode Island, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
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Pitel M, Phan O, Bonnaire C, Hamonniere T. Alcohol Use, Anxiety and Depression among French Grandes Écoles Engineering Students during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085590. [PMID: 37107872 PMCID: PMC10138594 DOI: 10.3390/ijerph20085590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/13/2023] [Accepted: 04/14/2023] [Indexed: 05/10/2023]
Abstract
In French Grandes Écoles, heavy alcohol consumption seems to be generalized and largely tolerated, leading to particular concerns about Alcohol Use Disorder and harmful alcohol practices among students. The COVID-19 pandemic led to increased psychological difficulties, and two coexisting scenarios seemed to emerge regarding alcohol consumption: A decrease in alcohol consumption linked to the absence of festive events, and an increase in solitary alcohol consumption to cope with lockdowns. The aim of this exploratory study is to investigate the evolution of alcohol consumption, consumption motives and the relationship of these factors to the anxiety and the depression of French Grandes Écoles students during the COVID-19 pandemic, depending on their residential status. After the last lockdown, 353 students completed a questionnaire measuring alcohol consumption, motivation to drink, anxiety and depression during and after the COVID-19 period. Although students confined to campus were more likely to increase their alcohol use, they also presented higher well-being scores than those who lived off campus. A significant proportion of students were aware of their increased alcohol use due to the COVID-19 pandemic, and the motives attributed to their increased consumption highlight the need for vigilance and specialized support facilities.
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Affiliation(s)
- Marion Pitel
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne Billancourt, France; (M.P.); (C.B.)
| | - Olivier Phan
- Centre de Soins d’Accompagnement et de Prévention en Addictologie Pierre Nicole, Croix-Rouge Française, 75005 Paris, France
- Service d’addictologie à l’adolescence, Clinique Dupré, Fondation Santé des Etudiants de France, Sceaux, 75005 Paris, France
- CESP Unité INSERM, 75005 Paris, France
- Laboratoire Parallélisme, UVSQ Paris, Saclay, 75005 Paris, France
| | - Céline Bonnaire
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100 Boulogne Billancourt, France; (M.P.); (C.B.)
- Centre de Soins d’Accompagnement et de Prévention en Addictologie Pierre Nicole, Croix-Rouge Française, 75005 Paris, France
| | - Tristan Hamonniere
- Service d’addictologie à l’adolescence, Clinique Dupré, Fondation Santé des Etudiants de France, Sceaux, 75005 Paris, France
- UR Clipsyd, Université Paris Nanterre, 92001 Nanterre, France
- Correspondence:
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Feinn R, Armeli S, Tennen H. Individual Differences in Affect Dynamics and Alcohol-Related Outcomes. Subst Use Misuse 2023; 58:967-974. [PMID: 37070645 PMCID: PMC10200030 DOI: 10.1080/10826084.2023.2201829] [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: 04/19/2023]
Abstract
Background: To examine whether individual differences in intensive longitudinal data-derived affective dynamics (i.e. positive and negative affect variability and inertia and positive affect-negative affect bipolarity) - posited to be indicative of emotion dysregulation - are uniquely related to drinking level and affect-regulation drinking motives after controlling for mean levels of affective states. Method: We used a large sample of college student drinkers (N = 1640, 54% women) who reported on their affective states, drinking levels and drinking motives daily for 30 days using a web-based daily diary. We then calculated from the daily data positive and negative affect variability, inertia, affect bipolarity and mean levels of affect and used these as predictors of average drinking level and affect-regulation drinking motives (assessed using both retrospective and daily reporting methods). Results: Findings from dynamic structural equation models indicated that mean levels of affect were uniquely related to drinking motives, but not drinking level. Few dynamic affect predictors were uniquely related to outcomes in the predicted direction after controlling for mean affect levels. Conclusion: Our results add to the inconsistent literature regarding the associations between affective dynamics and alcohol-related outcomes, suggesting that any effects of these indicators, after controlling for mean affect levels, might be more complex than can be detected with simple linear models.
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Affiliation(s)
- Richard Feinn
- Department of Medical Sciences, Quinnipiac University, Hamden, Connecticut, USA
| | - Stephen Armeli
- School of Psychology and Counseling, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| | - Howard Tennen
- Department of Public Health Sciences, UConn School of Medicine, Farmington, Connecticut, USA
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Bhuptani PH, Orchowski LM, Forkus SR, Newberger NG, Weiss NH. The Impact of Physical and Sexual Violence on Opioid Consequences among Trauma- exposed Individuals Recruited from the Community who Use Opioids. RESEARCH SQUARE 2023:rs.3.rs-2669901. [PMID: 36993534 PMCID: PMC10055686 DOI: 10.21203/rs.3.rs-2669901/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the United States. The current study evaluated the consequences associated with opioid use as a function of history of interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of sexual violence in the context of opioid use disorder treatment.
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Igra L, Shilon S, Kivity Y, Atzil-Slonim D, Lavi-Rotenberg A, Hasson-Ohayon I. Examining the associations between difficulties in emotion regulation and symptomatic outcome measures among individuals with different mental disorders. Front Psychol 2023; 14:944457. [PMID: 36998365 PMCID: PMC10043222 DOI: 10.3389/fpsyg.2023.944457] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundDifficulties in emotion regulation (ER) abilities have been found to play a central role in different psychiatric disorders. However, researchers rarely compare ER across different diagnostic groups. In the current study, we examined ER and its relation to functional and symptomatic outcome among three distinct diagnostic groups: people with schizophrenia (SCZ), people with emotional disorders (EDs; i.e., depression and/or anxiety), and individuals without any psychiatric diagnosis (controls).MethodsParticipants in this study comprised 108 adults who requested psychotherapy at a community clinic in the year 2015 and between 2017 and 2019. Clients were interviewed and filled out questionnaires measuring depression, distress, and difficulties in ER abilities.ResultsResults showed that individuals with psychiatric diagnoses reported higher levels of difficulties in ER abilities than did controls. Moreover, there were very few differences in levels of ER difficulty between SCZ and EDs. Further, the associations between maladaptive ER and psychological outcomes were significant in each diagnostic group, and especially for SCZ.ConclusionOur study indicates that difficulties in ER abilities partially have a transdiagnostic nature, and that these difficulties are associated with psychological outcomes among both clinical populations and controls. There were very few differences in levels of ER ability difficulties between SCZ and EDs, suggesting that the two groups share difficulties in relating and responding to emotional distress. The associations between difficulties in ER abilities and outcome were more robust and stronger among SCZ than the other groups, highlighting the potential contribution of targeting ER abilities in the treatment of schizophrenia.
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Teeters JB, Laves EH, King SA, Brausch AM. Gender Moderates the Association Between Cognitive Reappraisal and Alcohol-Related Problems Among Adolescents. Alcohol Alcohol 2023; 58:182-189. [PMID: 36905941 PMCID: PMC10008106 DOI: 10.1093/alcalc/agac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND/OBJECTIVE Alcohol use typically begins in adolescence, and the risk of later alcohol use disorders increases with earlier age of onset. Emotion dysregulation in adolescence has been linked to alcohol use. The present study seeks to extend previous findings by examining whether gender moderates the association between emotion regulation strategies (suppression and cognitive reappraisal) and alcohol-related problems in a longitudinal sample of adolescents. METHOD Data were collected as part of an ongoing study of high school students from the south-central region of the USA. The sample included 693 adolescents who participated in a study on suicidal ideation and risk behaviors. The majority of participants were girls (54.8%), white (85%) and heterosexual (87.7%). Baseline (T1) and 6-month follow-up (T2) data were analyzed for the present study. RESULTS Negative binomial moderation analyses revealed that gender moderated the association between cognitive reappraisal and alcohol-related problems, such that the association between reappraisal and alcohol-related problems was significantly stronger for boys than for girls. Gender did not moderate the association between suppression and alcohol-related problems. CONCLUSIONS The results suggest that emotion regulation strategies may be a particularly useful target for prevention and intervention efforts. Future research should consider tailoring adolescent alcohol prevention and intervention efforts focused on emotion regulation strategies by gender to bolster cognitive reappraisal skills and decrease suppression.
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Affiliation(s)
- Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, 1028 Kelly Thompson Hall, Bowling Green, KY 42101, USA
| | - Eliza H Laves
- Psychological Sciences Department, Western Kentucky University, 1028 Kelly Thompson Hall, Bowling Green, KY 42101, USA
| | - Shelby A King
- Psychology Department, East Tennessee State University, 420 Rogers Stout, Hall Johnson City, TN 37614, USA
| | - Amy M Brausch
- Psychological Sciences Department, Western Kentucky University, 1028 Kelly Thompson Hall, Bowling Green, KY 42101, USA
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Liu Q, Joiner RJ, Trichtinger LA, Tran T, Cole DA. Dissecting the depressed mood criterion in adult depression: The heterogeneity of mood disturbances in major depressive episodes. J Affect Disord 2023; 323:392-399. [PMID: 36455714 DOI: 10.1016/j.jad.2022.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Mood disturbances have historically remained a core criterion in diagnosing major depressive episode. DSMs have illustrated this criterion with depressed, hopeless, discouraged, cheerless, and irritable mood, suggesting interchangeability. Extant research has examined individual forms of mood disturbance to depression severity. Less examined is the heterogeneity in mood disturbances and its implication to their association to depression presentations and outcomes. METHOD The current study used a nationally representative sample of U.S. adults with unipolar major depressive disorder to study the association between specific forms of mood disturbances to depression severity, chronicity, or symptoms, above and beyond other forms, as well as their relations to functional impairment, suicidal outcomes, and psychiatric comorbidity via generalized linear models. RESULTS Cheerless and hopeless mood were associated with depression severity. Hopeless and irritable mood were associated with depression chronicity. Different forms of mood disturbance showed differential relations to depressive symptoms. Cheerless, hopeless, and irritable mood were associated with depression-specific functional interference, incremental to depression severity. Cheerless, hopeless, and discouraged mood were associated with passive suicidal ideation. Hopeless mood was associated with active suicidal ideation. Hopeless and irritable mood were associated with both suicide plan and suicide attempt. Different forms of mood disturbance demonstrated differential associations to comorbid psychiatric conditions. DISCUSSION The relations between different forms of mood disturbances and various aspects of depression are nuanced. Theoretically, these relations highlight the potential utility in acknowledging the complexity and heterogeneity in mood disturbances. Clinically, our results suggest potential utility in routinely monitoring mood disturbances.
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Affiliation(s)
- Qimin Liu
- Department of Psychology and Human Development, Vanderbilt University, United States of America.
| | - Raquael J Joiner
- Department of Psychology, Unviersity of California, Los Angeles, United States of America
| | - Lauren A Trichtinger
- Department of Mathematics, Computing, and Statistics, Simmons University, United States of America
| | - Tiffany Tran
- Department of Psychology and Human Development, Vanderbilt University, United States of America
| | - David A Cole
- Department of Psychology and Human Development, Vanderbilt University, United States of America
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Pinto TM, Jongenelen I, Lamela D, Pasion R, Morais A, Costa R. Childbirth-related post-traumatic stress disorder symptoms and mother-infant neurophysiological and behavioral co-regulation during dyadic interaction: study protocol. BMC Psychol 2023; 11:37. [PMID: 36759926 PMCID: PMC9909987 DOI: 10.1186/s40359-023-01070-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Mother's childbirth-related posttraumatic stress disorder (PTSD) symptoms have a negative impact on mother and infant's behaviors during dyadic interactions which may increase mother-infant neurophysiological and behavioral co-regulation difficulties, leading to dysregulated mother-infant interactions. This study was specifically designed to analyze: (1) the sociodemographic and obstetric factors associated with mother's childbirth-related PTSD symptoms; (2) mother-infant neurophysiological functioning and behavioral co-regulation during dyadic interaction; (3) the impact of mother's childbirth-related PTSD symptoms on neurophysiological and behavioral mother-infant co-regulation during dyadic interaction; (4) the moderator role of previous trauma on the impact of mother's childbirth-related PTSD symptoms on neurophysiological and behavioral mother-infant co-regulation during dyadic interaction; and (5) the moderator role of comorbid symptoms of anxiety and depression on the impact of mother's childbirth-related PTSD symptoms on neurophysiological and behavioral mother-infant co-regulation during dyadic interaction. METHODS At least 250 mothers will be contacted in order to account for refusals and dropouts and guarantee at least 100 participating mother-infant dyads with all the assessment waves completed. The study has a longitudinal design with three assessment waves: (1) 1-3 days postpartum, (2) 8 weeks postpartum, and (3) 22 weeks postpartum. Between 1 and 3 days postpartum, mothers will report on-site on their sociodemographic and obstetric characteristics. At 8 weeks postpartum, mothers will complete online self-reported measures of birth trauma, previous trauma, childbirth-related PTSD, anxiety, and depressive symptoms. At 22 weeks postpartum, mothers will complete online self-reported measures of childbirth-related PTSD, anxiety, and depressive symptoms. Mothers and infants will then be home-visited to observe and record their neurophysiological, neuroimaging and behavioral data during dyadic interactions using the Still-face Paradigm. Activation patterns in the prefrontal cortices of mother and infant will be recorded simultaneously using hyperscanning acquisition devices. Unadjusted and adjusted multilevel linear regression models will be performed to analyze objectives 1 to 3. Moderation models will be performed to analyze objectives 4 and 5. DISCUSSION Data from this study will inform psychological interventions targeting mother-infant interaction, co-regulation, and infant development. Moreover, these results can contribute to designing effective screenings to identify mothers at risk of perinatal mental health problems and those who may need specialized perinatal mental health care.
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Affiliation(s)
- Tiago Miguel Pinto
- Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098, Porto, Portugal.
| | - Inês Jongenelen
- grid.164242.70000 0000 8484 6281Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098 Porto, Portugal
| | - Diogo Lamela
- grid.164242.70000 0000 8484 6281Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098 Porto, Portugal
| | - Rita Pasion
- grid.164242.70000 0000 8484 6281Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098 Porto, Portugal
| | - Ana Morais
- grid.164242.70000 0000 8484 6281Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098 Porto, Portugal
| | - Raquel Costa
- grid.164242.70000 0000 8484 6281Digital Human-Environment Interaction Labs (HEI-Lab), Lusófona University, R. de Augusto Rosa 24, 4000-098 Porto, Portugal ,grid.5808.50000 0001 1503 7226EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal ,grid.5808.50000 0001 1503 7226Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
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Kirk-Provencher KT, Penner AE, McRae K, Gowin JL. Emotion regulation in young adults with family history of harmful alcohol use: A fMRI study. Drug Alcohol Depend 2023; 243:109752. [PMID: 36610254 PMCID: PMC9875721 DOI: 10.1016/j.drugalcdep.2022.109752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/31/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Alcohol use disorder is associated with difficulties in emotion regulation and cognitive reappraisal. Family history of harmful alcohol use increases risk of substance use disorders, but no studies have examined whether family history is associated with altered neural activation during cognitive reappraisal relative to passive viewing of negative images in a sample of young adults without current substance use disorders. METHODS Participants (N = 75 with positive [n = 31] or negative [n = 44] family histories of harmful alcohol use) completed the emotion regulation task during an MRI scan, and the Emotion Regulation Questionnaire to assess use of emotion regulation and suppression strategies. Whole-brain analyses and amygdala region of interest analyses using linear mixed-effects models assessed family history group and cue effects on neural activation during the task. RESULTS The groups did not differ on trait reappraisal, suppression, or negative emotion following reappraisal. In general, group effects in whole-brain and amygdala activation during the cognitive reappraisal contrast indicated small effect sizes (2.2% of voxels had d>0.20) that were not significantly different. Participants with positive family histories engaged the right middle and superior frontal gyri to a greater extent than participants with negative family histories during the decrease-negative cue (t = 4.14, p = .001). CONCLUSIONS For at-risk young adults without current harmful substance use, family history of harmful alcohol use does not appear to be associated with disrupted emotion regulation when instructed to apply cognitive reappraisal. Reappraisal may be a feasible therapeutic target for those who develop a substance use disorder with associated emotion dysregulation.
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Affiliation(s)
- Katelyn T Kirk-Provencher
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States.
| | - Anne E Penner
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Aurora, CO 80045, United States.
| | - Kateri McRae
- Department of Psychology, University of Denver, 2155S. Race Street, Denver, CO 80208, United States.
| | - Joshua L Gowin
- Department of Radiology, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E. 19th Avenue, Aurora, CO 80045, United States.
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Bowdring MA, Loftus P, Wang SD, Pang RD, Kirkpatrick MG. Interactive associations between abstinence plans and romantic partner conflict and support with cigarette smoking. Drug Alcohol Depend 2023; 243:109756. [PMID: 36608484 DOI: 10.1016/j.drugalcdep.2022.109756] [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: 04/29/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND While most individuals who smoke cigarettes desire to quit, quit motivation can change daily and sustained abstinence is rarely achieved in quit attempts. Assessment of psychosocial factors that moderate associations between daily abstinence intentions and smoking behavior is necessary to inform effective cessation efforts. METHODS A secondary analysis was conducted using data from a 28-day ecological momentary assessment study among individuals who smoke and who were not actively planning a long-term quit attempt (N = 81 individuals; N = 1585 days). We examined main effect and interaction associations between primary predictors (daily abstinence plans and within- and between-person estimates of perceived romantic relationship conflict and support) and daily number of cigarettes smoked, as well as baseline emotion regulation difficulties as a moderator of these associations. RESULTS Smoking was reduced on days with an abstinence plan (β=-0.57,p<.001), especially among individuals with lower average levels of conflict (plan × between-person conflict interaction: β=0.98, p < .001), and higher average levels of support (plan × between-person support interaction: β=0.26, p < .001). Additionally, smoking was increased on days when participants had higher levels of conflict than usual (β=0.07, p < .01), but only on days when participants did not have a plan (plan × within-person conflict interaction:β=-0.10, p < .05). Emotion regulation difficulties did not moderate any associations. CONCLUSION This study adds to the literature on the influence of negative aspects of social experience on smoking behavior. Further, the present study underlines the importance of assessing the influence of both positive and negative aspects of - and within- and between-person differences in - social experiences.
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Affiliation(s)
- Molly A Bowdring
- Stanford University School of Medicine, Stanford Prevention Research Center, 3180 Porter Drive, Palo Alto, CA, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, 401 Quarry Road, Stanford, CA 94305, USA.
| | - Paddy Loftus
- University of South Florida, Department of Psychology, 4202 E Fowler Ave, Tampa, FL 33620, USA.
| | - Shirlene D Wang
- University of Southern California, Department of Population and Public Health Sciences, 2001 N Soto St, Los Angeles, CA 90032, USA.
| | - Raina D Pang
- University of Southern California, Department of Population and Public Health Sciences, 2001 N Soto St, Los Angeles, CA 90032, USA; University of Southern California, Department of Psychology, 3620S. McClintock Ave., Los Angeles, CA 90089, USA.
| | - Matthew G Kirkpatrick
- University of Southern California, Department of Population and Public Health Sciences, 2001 N Soto St, Los Angeles, CA 90032, USA; University of Southern California, Department of Psychology, 3620S. McClintock Ave., Los Angeles, CA 90089, USA.
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Rodriguez L, Read JP. Trauma cue-elicited emotional response profiles influence acute experiences of alcohol urge. J Behav Ther Exp Psychiatry 2022; 77:101772. [PMID: 36113909 DOI: 10.1016/j.jbtep.2022.101772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/24/2022] [Accepted: 07/29/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Affective responses to trauma cues in individuals with posttraumatic stress (PTS) can evoke a desire to drink and may shed light on novel mechanisms of PTS-drinking. The present study aimed to (1) identify and characterize patterns of acute emotional responses (ER) to trauma cues and (2) examine how these patterns influence drinking urge. METHODS University students (N = 304; Mage = 19; 52.3% female) completed a structured clinical interview to confirm trauma history and PTS. At an experimental session one week later, participants completed a series of three trauma cue exposures. Affect and drinking urge were measured at baseline, after each cue exposure, and at experiment's end. RESULTS Latent profile analysis of ER yielded a five-profile solution: (1) Nonresponders (2) Low Responders (3) Moderate Responders (4) Resilient Responders and (5) High Responders. Profiles differed by trait neuroticism, PTS, and emotion dysregulation, with High Responders as the most severe group. In latent growth curve models, profiles significantly predicted alcohol urge trajectories in a graded pattern. High Responders, with the greatest affective intensity, showed the strongest urge. Duration of affect was also implicated with Resilient Responders, who had similar intensity but faster overall affective recovery time compared to High Responders, demonstrating lower mean levels of urge. LIMITATIONS External validity is limited. CONCLUSIONS Individual differences in ER to trauma cues are important for understanding alcohol urge. Findings can inform integrative treatments for PTS-drinking by targeting ER to shorten affective recovery to trauma reminders and reduce the need for alcohol use as a regulation strategy.
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Affiliation(s)
- Lauren Rodriguez
- Department of Psychology, State University of New York, University at Buffalo, USA; 386 Park Hall, Buffalo, NY, 14260-4110, USA.
| | - Jennifer P Read
- Department of Psychology, State University of New York, University at Buffalo, USA; 231 Park Hall, Buffalo, NY, 14260-4110, USA.
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Weiss NH, Brick LA, Schick MR, Forkus SR, Raudales AM, Contractor AA, Sullivan TP. Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro-longitudinal study of community women experiencing intimate partner violence. Addiction 2022; 117:3150-3169. [PMID: 35792057 DOI: 10.1111/add.15992] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post-traumatic stress disorder (PTSD). DESIGN Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording. SETTING Northeastern United States. PARTICIPANTS A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020. MEASUREMENTS Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview. FINDINGS Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation. CONCLUSIONS Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.
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Affiliation(s)
| | | | - Melissa R Schick
- University of Rhode Island, Kingston, RI, USA.,Medical University of South Carolina, Charleston, SC, USA
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Pilkington PD, May T, Karantzas G. Recollections of Parental Mental Illness and Substance Use and Early Maladaptive Schemas in Adulthood. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00969-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Macmadu A, Frueh L, Collins AB, Newman R, Barnett NP, Rich JD, Clark MA, Marshall BDL. Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103792. [PMID: 35816791 PMCID: PMC9462427 DOI: 10.1016/j.drugpo.2022.103792] [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: 04/27/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Scant research has examined the influence of overdoses occurring in social networks (i.e., knowing someone who has overdosed) on individual overdose risk. We sought to characterize drug use behaviors of individuals following the overdose of someone in their social network. METHODS We conducted semi-structured interviews with 25 people who use drugs and knew someone who overdosed in the prior 90 days. All interviews were conducted in person in Rhode Island from July to October 2021. Data were stratified by drug use behaviors following the overdose of a network member (i.e., risk behaviors, protective behaviors, no change; selected a priori) and analyzed using a thematic analysis variation to identify salient themes. RESULTS We identified variation in the effect of knowing someone who overdosed on subsequent drug use behaviors and emotional affect. Several participants described increasing their drug use or using more types of drugs than usual to manage feelings of bereavement and trauma, and a subset of these participants described increased drug use with suicidal intention and increased suicidal ideations following the overdose event. Other participants described reducing their drug use and engaging in protective behaviors in response to heightened perceived overdose risk, protection motivation (i.e., increased motivation to protect oneself), and concern for others. Additionally, some participants reported no change in drug use behaviors, and these participants described already engaging in harm reduction practices, feeling desensitized due to frequent or repeated exposure to overdose, and ambivalence about living. CONCLUSIONS Findings suggest a need for enhanced investment in network-based overdose prevention interventions, as well as more robust integration of bereavement support and mental health services in settings that serve people who use drugs. The findings also suggest a need for future research to identify mediators of the effect of overdose occurring in social networks on individual overdose risk.
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Affiliation(s)
- Alexandria Macmadu
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA
| | - Lisa Frueh
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
| | - Alexandra B Collins
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA
| | - Roxxanne Newman
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA
| | - Nancy P Barnett
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA
| | - Josiah D Rich
- The Center for Health + Justice Transformation, The Miriam Hospital, 1125 North Main Street, Providence, RI, USA
| | - Melissa A Clark
- Department of Health Services, Policy & Practice, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, USA.
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Weiss NH, Brick LA, Forkus SR, Goldstein SC, Thomas ED, Schick MR, Barnett NP, Contractor AA, Sullivan TP. Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro-longitudinal study. Alcohol Clin Exp Res 2022; 46:1460-1471. [PMID: 35676805 PMCID: PMC11100457 DOI: 10.1111/acer.14881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/27/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level. METHODS Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording. RESULTS Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects. CONCLUSIONS Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.
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Affiliation(s)
| | | | | | | | | | - Melissa R. Schick
- University of Rhode Island, Kingston, Rhode Island, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
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Tovmasyan A, Monk RL, Sawicka I, Heim D. Positive but not negative affect is associated with increased daily drinking likelihood in non-clinical populations: systematic review and meta-analyses. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:382-396. [PMID: 35767656 DOI: 10.1080/00952990.2022.2082300] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/17/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Background: Recent meta-analytical findings indicate that affect regulation plays an important role in alcohol craving, consumption volume, and substance use. However, in view of mixed findings, the affect and drinking likelihood literature remains in need of clarification and consolidation.Objectives: This systematic review with meta-analyses interrogated the results from peer-reviewed studies among non-clinical populations that examined the relationship between daily affective states and intraday likelihood of alcohol consumption.Method: A PRISMA guided search of PsychINFO, PsycARTICLES, Science Direct, Wiley Online Library, PubMed, SCOPUS, and JSTOR databases was conducted. Multilevel meta-analyses yielded 11 eligible negative affect studies (2751 participants, 23 effect sizes) and nine studies on positive affect (2244 participants, 14 effect sizes).Results: The pooled associations between intra-day affect and alcohol consumption likelihood revealed no significant association between negative affective state and drinking likelihood (OR = .90, 95% CI [.73, 1.12]) and that positive affect was associated with increased drinking likelihood (OR = 1.17, 95% CI [1.09, 1.27]). Egger's test, P-curve, fail-safe N, and selection models analyses suggested that the obtained results were unlikely to be the product of publication bias and p-hacking alone.Conclusions: Results converge to suggest that, independent of age, affect measure used, and study design, a significant albeit modest relationship between positive affect and alcohol consumption likelihood exists, which does not appear to be the case for negative affect. In conjunction with other recent meta-analyses, current findings help map out a more nuanced understanding of the affect-alcohol/substance use relationship, with potential implications for interventions.
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Affiliation(s)
- Anna Tovmasyan
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool, United Kingdom
| | - Rebecca L Monk
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool, United Kingdom
| | - Ilona Sawicka
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Derek Heim
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
- Liverpool Centre for Alcohol Research, Liverpool, United Kingdom
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Zengin İspir G, Danışman M, Tulacı RG, Özdel K. Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder: the preliminary results of a prospective study. J Addict Dis 2022:1-8. [PMID: 35713278 DOI: 10.1080/10550887.2022.2087449] [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: 10/18/2022]
Abstract
BACKGROUND Substance use disorder is a growing health problem all over the world. The coexistence of substance misuse, affective temperaments, and emotion dysregulation has not been studied sufficiently. OBJECTIVE The present study aimed to evaluate the role of affective temperaments and emotion dysregulation on substance use disorder. The Emotion Dysregulation and Affective Temperaments in Opioid Use Disorder study was designed observational. This paper presents only the baseline assessments of the patient and control groups. One-year remission rates of the patients' group will be reported elsewhere after 1-year follow-up. METHODS Sixty-seven patients with opioid use disorder and 68 healthy controls enrolled. All participants were administered to The Structured Clinical Interview for DSM-5, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionnaire, Difficulties in Emotion Regulation Scale, Beck Anxiety Inventory, and Beck Depression Inventory. RESULTS Patients with opioid use disorder had higher scores from all temperamental scales and showed higher difficulties on emotion regulation than the control group. Even controlling the confounding effects of anxiety and depression levels, dysthymic and anxious temperament scores were found correlated with the emotion dysregulation score in the patient group. CONCLUSIONS The emotional traits (i.e., affective temperaments) and emotion regulation abilities play a crucial role in substance use disorder. While managing substance use disorder, being aware of affective temperament characteristics and/or interventions to improve emotion regulation skills may be helpful.
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Affiliation(s)
- Gamze Zengin İspir
- University of Health Science-Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey
| | | | - Rıza Gökçer Tulacı
- University of Health Science-Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey
| | - Kadir Özdel
- University of Health Science-Diskapi Yildirim Beyazit Teaching and Research Hospital, Ankara, Turkey
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Saeedi Rashkolia A, Manzari Tavakoli A, Zeinaddiny Meymand Z, Hosseini Fard SM. The Effectiveness of Interpersonal Psychotherapy on Alexithymia, Emotion Regulation, and Psychological Capital of Male Substance Abusers Treated by Addiction Treatment Centers in Kerman. ADDICTION & HEALTH 2022; 14:127-137. [PMID: 36544512 PMCID: PMC9743814 DOI: 10.22122/ahj.2022.196559.1295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 01/19/2022] [Indexed: 12/24/2022]
Abstract
Background Addiction is a psychiatric disorder with biological, psychological, and social aspects. Literatures indicated that alexithymia, emotional dysregulation, and low psychological capital affect substance abuse. This study investigated the effectiveness of interpersonal psychotherapy on alexithymia, emotional regulation, and psychological capital of male substance abusers. Methods This quasi-experimental study was conducted in 2021 in Kerman, Iran using a pretest, post-test design with a control group. A single therapy center was randomly selected via the multi-stage cluster method from several substance abuse treatment centers. 50 people were randomly selected and allocated to experimental and control groups. The research instruments were questionnaires for alexithymia, emotional regulation, and psychological capital. After the pretest phase, the experimental group underwent 12 sessions of interpersonal psychotherapy. In the next step, the post-test was conducted and after 6 weeks the follow-up test was performed on the groups. The control group did not receive the treatment. Finally, the data obtained from 40 participants were analyzed using the MANCOVA test by SPSS25 statistical software. Findings Our findings indicated significant MANCOVA results for alexithymia (F=65.14 and P<0.05), emotion regulation (F=44.72 and P<0.05) and psychological capital (F=12.05 and P<0.05) showing a significant difference between the scores of dependent variables in the experimental group and control group. Conclusion The results showed that interpersonal psychotherapy improves the state of alexithymia, emotional regulation, and psychological capital in substance abusers. It can also be used as an effective intervention in addiction treatment centers.
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Affiliation(s)
| | - Alireza Manzari Tavakoli
- Department of Psychology and Educational Sciences, Kerman Branch, Islamic Azad University, Kerman, Iran,Correspondence to: Alireza Manzari Tavakoli; Department of Psychology and Educational Sciences, Kerman Branch, Islamic Azad University, Kerman, Iran;
| | - Zahra Zeinaddiny Meymand
- Department of Psychology and Educational Sciences, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Seyed Mehdi Hosseini Fard
- Department of General Education, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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Mistler CB, Idiong CI, Copenhaver MM. Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder. Front Public Health 2022; 10:825988. [PMID: 35223742 PMCID: PMC8866309 DOI: 10.3389/fpubh.2022.825988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting. METHODS We conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment. RESULTS Two main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions. CONCLUSIONS Accommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.
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Affiliation(s)
- Colleen B. Mistler
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
| | - Christie I. Idiong
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
| | - Michael M. Copenhaver
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, United States
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