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Stull SW, Linden-Carmichael AN, Scott CK, Dennis ML, Lanza ST. Time-varying effect modeling with intensive longitudinal data: Examining dynamic links among craving, affect, self-efficacy and substance use during addiction recovery. Addiction 2023; 118:2220-2232. [PMID: 37416972 DOI: 10.1111/add.16284] [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: 09/19/2022] [Accepted: 05/22/2023] [Indexed: 07/08/2023]
Abstract
Time-varying effect modeling (TVEM), a statistical technique for modeling dynamic patterns of change, presents new opportunities to study biobehavioral health processes. TVEM is particularly useful when applied to intensive longitudinal data (ILD) because it permits highly flexible modeling of outcomes over continuous time, as well as of associations between variables and moderation effects. TVEM coupled with ILD is ideal for the study of addiction. This article provides a general overview of using TVEM, particularly when applied to ILD, to better enable addiction scientists to conduct novel analyses that are important to realizing the dynamics of addiction-related processes. It presents an empirical example using ecological momentary assessment data from participants throughout their first 90 days of addiction recovery to estimate the (1) associations between morning craving and same-day recovery outcomes, (2) association between morning positive and negative affect and same-day recovery outcomes and (3) time-varying moderation effects of affect on the association between morning craving and recovery outcomes. We provide a didactic overview in implementing and interpreting the aims and results, including equations, computer syntax and reference resources. Our results highlight how affect operates as both a time-varying risk and protective factor on recovery outcomes, particularly when considered in combination with experiences of craving (i.e. dynamic moderation). We conclude by discussing our results, recent innovations and future directions of TVEM for advancing addiction science, including how 'time' can be operationalized to probe new research questions.
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Affiliation(s)
- Samuel W Stull
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Ashley N Linden-Carmichael
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, University Park, PA, USA
| | | | | | - Stephanie T Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, University Park, PA, USA
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Rudolph JE, Cepeda JA, Astemborski J, Kirk GD, Mehta SH, Genberg BL. Trajectories of drug treatment and illicit opioid use in the AIDS Linked to the IntraVenous Experience cohort, 2014-2019. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104120. [PMID: 37429162 PMCID: PMC10528295 DOI: 10.1016/j.drugpo.2023.104120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Medication for opioid use disorder (MOUD) is an effective intervention to combat opioid use disorder and overdose, yet there is limited understanding of engagement in treatment over time in the community, contextualized by ongoing substance use. We aimed to identify concurrent trajectories of methadone prescriptions, buprenorphine prescriptions, and illicit opioid use among older adults with a history of injection drug use. METHODS We used data on 887 participants from the AIDS Linked to the IntraVenous Experience cohort, who were engaged in the study in 2013 and attended ≥1 visit during follow-up (2014-2019). Outcomes were self-reported MOUD prescription and illicit opioid use in the last 6 months. To identify concurrent trajectories in all 3 outcomes, we used group-based multi-trajectory modeling. We examined participant characteristics, including sociodemographics, HIV status, and other substance use, overall and by cluster. RESULTS We identified 4 trajectory clusters: (1) no MOUD and no illicit opioid use (43%); (2) buprenorphine and some illicit opioid use (11%); (3) methadone and no illicit opioid use (28%); and (4) some methadone and illicit opioid use (18%). While prevalence of each outcome was stable across time, transitions on/off treatment or on/off illicit opioid use occurred, with the rate of transition varying by cluster. The rate of transition was highest in Cluster 3 (0.74/person-year) and lowest in Cluster 1 (0.18/person-year). We saw differences in participant characteristics by cluster, including that the buprenorphine cluster had the highest proportion of people with HIV and participants who identified as non-Hispanic Black. CONCLUSIONS Most participants had discontinued illicit opioid use and were also not accessing MOUD. Trajectories defined by engagement with buprenorphine or methadone had distinct sociodemographic and behavioral characteristics, indicating that tailored interventions to expand access to both types of treatment are likely needed to reduce harms associated with untreated opioid use disorder.
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Affiliation(s)
- Jacqueline E Rudolph
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Javier A Cepeda
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jacquie Astemborski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Gregory D Kirk
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Shruti H Mehta
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Becky L Genberg
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Votaw VR, Tuchman FR, Piccirillo ML, Schwebel FJ, Witkiewitz K. Examining Associations Between Negative Affect and Substance Use in Treatment-Seeking Samples: A Review of Studies Using Intensive Longitudinal Methods. CURRENT ADDICTION REPORTS 2022; 9:445-472. [PMID: 37063461 PMCID: PMC10101148 DOI: 10.1007/s40429-022-00441-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review Understanding dynamic relationships between negative affect and substance use disorder (SUD) outcomes, including craving, may help inform adaptive and personalized interventions. Recent studies using intensive longitudinal methods were reviewed to examine relationships between negative affect and the outcomes of either craving or substance use during and following SUD treatment. Recent Findings Results on associations between negative affect and craving/substance use were mixed and difficult to synthesize, given methodological differences across studies. The strength and direction of these relationships varied across outcomes, subgroups, contexts, and time course. Summary The current literature is mixed concerning negative affect and craving/substance use associations during and following SUD treatment. Researchers should increasingly recruit diverse individuals, for example, samples of varying racial and ethnic backgrounds and those reporting co-occurring disorders and polysubstance use. Experimental, qualitative, and person-specific methods will improve our understanding of relationships between negative affect and substance-related outcomes during SUD treatment.
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Affiliation(s)
- Victoria R Votaw
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
| | - Felicia R Tuchman
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Department of Psychology, Northwestern University, Evanston, IL
| | | | - Frank J Schwebel
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
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Zhao X, Xu B, Duan W, Chang L, Tan R, Sun Z, Ye Z. Insights into Exosome in the Intervertebral Disc: Emerging Role for Disc Homeostasis and Normal Function. Int J Med Sci 2022; 19:1695-1705. [PMID: 36237988 PMCID: PMC9553858 DOI: 10.7150/ijms.75285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
Abstract
Low back pain (LBP) is a chronic condition that causes great individual suffering and economic burden. The major contributor of LBP is intervertebral disc degeneration (IDD), which is caused by a spectrum of homeostasis alteration, including the apoptosis of nucleus pulposus (NP) and annulus fibrosus (AF) cells, degradation of extracellular matrix (ECM), calcification of cartilaginous endplates (CEP) and so on. Currently, the therapeutic strategy for IDD includes conservative and surgery treatment. Nevertheless, none of them could reverse the progressive destruction of the intervertebral disc. Hence, it is pivotal to pursue a new therapeutic approach. Exosomes, nano-sized substances with diameters of 30-150 nm, can be synthesized and secreted by various types of cells. They play an important role in intercellular communication. Increasing evidence implicates that exosomes could impact the intracellular transcription activities, thereby inhibiting or accelerating the proliferation and apoptosis of cells. Thus, it is a new therapeutic source for IDD. This review chiefly focuses on generalizing and clarifying the roles of exosomes in the onset and deterioration of IDD, and their therapeutic potential.
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Affiliation(s)
- Xin Zhao
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Benchi Xu
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Wei Duan
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Le Chang
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Rui Tan
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Zhen Sun
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
| | - Zhengxu Ye
- Department of Orthopedic, Xijing Hospital, Fourth Military Medical University. Western Changle Road, Xi'an, 710032, Shannxi Provence, P. R. China
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