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Mattingley S, Youssef GJ, Graeme L, Sloan E, Manning V, Hall K. Negative urgency, distress tolerance, and symptoms of substance use, eating, and borderline personality disorders in treatment-seeking young people. J Clin Psychol 2024; 80:261-278. [PMID: 37597248 DOI: 10.1002/jclp.23579] [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: 11/05/2022] [Revised: 04/24/2023] [Accepted: 07/23/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE Negative urgency (NU) and distress tolerance (DT) are two similar yet distinct constructs with putative transdiagnostic relevance, particularly across psychopathology characterized by impulsivity (e.g., substance use disorders [SUD], eating disorders featuring binging and/or purging ED-B/P, and borderline personality disorder [BPD]). Yet, there remains a lack of research into NU and DT across SUD, ED-B/P, and BPD symptomatology in clinical populations. The present study sought to elucidate the transdiagnostic utility of NU and DT across impulsive-type psychology by examining the unique and interactive roles of NU and DT across SUD, ED-B/P, and BPD symptomatology within a treatment-seeking sample of young people. METHOD Participants (N = 385; 62.3% female; aged 16-25 years) were recruited from youth health services across Melbourne, Australia. Participants completed an online survey including self-report measures of NU and DT as well as SUD, ED-B/P, and BPD symptoms. Mixed effects logistic regression was used to explore unique and interactive associations of NU and DT with symptoms. RESULTS Both NU (adjusted odds ratio [ORadj ] = 1.22; 95% confidence interval [CI] = [1.16, 1.28]) and global DT (ORadj = 0.59; 95% CI = [0.47, 0.74]) uniquely predicted symptoms. However, associations with global DT and most of its components differed across psychopathology types. No significant interactions between NU and DT in predicting symptoms were found. CONCLUSIONS These results support the transdiagnostic utility of NU across SUD, ED-B/P, and BPD, while suggesting the role of DT across these disorders is more nuanced. These findings have important implications for NU and DT as potential intervention targets.
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Affiliation(s)
- Sophie Mattingley
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - George J Youssef
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Liam Graeme
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Elise Sloan
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Victoria Manning
- Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
- Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Kate Hall
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre of Drug Use, Addictive and Antisocial Behavior Research, Deakin University, Geelong, Victoria, Australia
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Barrios L, Stamatovich SN, Simons RM, Simons JS. Reinforcement sensitivity and bulimia symptoms: the role of emotion regulation. Eat Weight Disord 2022; 27:1593-1602. [PMID: 34546555 DOI: 10.1007/s40519-021-01275-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/20/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Reinforcement Sensitivity Theory (RST) provides a theoretical foundation associated with various approach and avoidance behaviors and individual personality differences. Sensitivity to reward and punishment, two neural systems within the RST have been significantly associated with bingeing and purging behaviors. However, inconsistent findings are observed and specific factors mediating these relationships are not well understood. Deficits in emotion regulation may account for these relationships, as both negative urgency and distress tolerance have been independently associated with bulimia behaviors. Thus, this is an area that requires further investigation. METHOD The current study utilized various self-report inventories, including the Eating Disorder Inventory-3rd Edition to measure bulimia symptoms, as well as measures of negative affect, sensitivity to reward and punishment, distress tolerance, and negative urgency. These measures were used to assess whether distress tolerance and negative urgency mediated associations between sensitivity to reward and punishment and bulimia symptoms in a community sample of 394 young adults ranging from the ages of 18 to 25. RESULTS As expected, sensitivity to reward and punishment were significantly associated with decreased distress tolerance. Distress tolerance was also directly associated with greater negative urgency, which was significantly associated with increased bulimia symptoms. Consistent with hypotheses, indirect associations between sensitivity to reward and sensitivity to punishment to bulimia symptoms via distress tolerance and negative urgency were observed, controlling for gender and negative affect. DISCUSSION Results contribute to understanding specific contributions of risk factors within the relationship of sensitivity to reward and punishment and bulimia symptoms, measured by the EDI-3. Novel to existing literature, results indicate that reinforcement sensitivity significantly contributes to emotion regulation deficits. Thus, these findings may have important implications for understanding the development and treatment of bulimia symptoms. LEVEL OF EVIDENCE Level V, based on descriptive, cross-sectional data.
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Affiliation(s)
- Lindsey Barrios
- Department of Psychology, University of South Dakota, Vermillion, SD, USA.
| | | | - Raluca M Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, SD, USA
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3
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Mattingley S, Youssef GJ, Manning V, Graeme L, Hall K. Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis. J Affect Disord 2022; 300:492-504. [PMID: 34986376 DOI: 10.1016/j.jad.2021.12.126] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/08/2021] [Accepted: 12/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Distress tolerance (DT) has received increased attention in recent years due to its purported role in dysregulated behaviours and their clinical manifestations, such as problematic substance use (PSU), disordered eating behaviours (e.g., binge-eating and purging; DEB), and borderline personality disorder (BPD) symptomatology. Despite the proposed transdiagnostic utility of DT across PSU, DEB, and BPD, there has yet to be a systematic and comprehensive examination characterising and comparing its association with this class of impulsive-type psychopathology. METHODS A systematic search was conducted across five electronic databases using search terms designed to capture extant literature on the association between DT and PSU, DEB, and BPD symptomatology. A series of meta-analyses were undertaken on correlation coefficients from 81 studies to examine the association between DT and each psychopathology domain, as well as impulsive-type psychopathology overall. Moderator analyses were conducted to examine whether these relationships were moderated by DT measurement type, sample type, age, and gender. RESULTS DT shared significant, negative, medium correlations with PSU (r = -.18,), DEB (r = -.20), and BPD symptomatology (r = -.27). The magnitude of these associations was not significantly different across the three psychopathology domains, supporting transdiagnostic conceptualisation. DT measurement type, age, and sample type moderated several of these indicated relationships. LIMITATIONS The majority of studies were conducted in adult samples from Western countries, limiting understanding of these relationships across development and different cultures. CONCLUSIONS The present findings support the putative transdiagnostic role of DT across PSU, DEB, and BPD, which may ultimately inform novel, cross-cutting interventions.
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Affiliation(s)
| | - George J Youssef
- Deakin University, Geelong, Australia, School of Psychology; Centre for Drug Use, Addictive, and Anti-social Behaviour Research (CEDAAR), Deakin University, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Victoria Manning
- Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Monash University, Australia; Turning Point, Eastern Health, Australia
| | - Liam Graeme
- Deakin University, Geelong, Australia, School of Psychology
| | - Kate Hall
- Deakin University, Geelong, Australia, School of Psychology; Centre for Drug Use, Addictive, and Anti-social Behaviour Research (CEDAAR), Deakin University, Australia.
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4
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Identifying and Managing Eating Disorders in Persons Presenting for Addiction Treatment. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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5
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Kelly NR, Kosty D, Guerricabeitia L, Guidinger C, Williamson G. Evaluating components of existing theories for loss of control eating in a sample of young racially/ethnically diverse men. Body Image 2020; 35:63-70. [PMID: 32877842 DOI: 10.1016/j.bodyim.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/06/2020] [Accepted: 08/16/2020] [Indexed: 01/23/2023]
Abstract
The current study evaluated components of existing theoretical models for loss of control (LOC) eating in young men. The link between body image concerns, including concerns with fat and muscularity, and LOC eating frequency was evaluated in 1109 ethnically/racially diverse men (18-30y). Dietary restraint, compulsive exercise, and emotion dysregulation were evaluated as putative mediators. Body mass index (BMI) and race/ethnicity were examined as moderators. Participants completed online surveys. Path analyses in Mplus tested indirect paths using the bias-corrected bootstrap method. Higher body fat concerns were directly linked to LOC eating frequency and indirectly linked through greater dietary restraint, compulsive exercise, and emotional dysregulation (ps<.01). The link among fat concerns, restraint, and LOC eating frequency was moderated by body mass, such that this association was particularly strong for men with a low-to-average BMI relative to those with a high BMI (p < .001). Higher muscularity concerns were not directly linked to LOC eating frequency but were indirectly linked through greater emotion dysregulation (p < .001). Body image concerns are associated with LOC eating in young men. The pathways to LOC eating may differ depending on the nature of men's body image concerns (muscularity vs. thinness). Prospective data are needed to verify these findings.
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Affiliation(s)
- Nichole R Kelly
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States.
| | - Derek Kosty
- The Prevention Science Institute, University of Oregon, United States
| | | | - Claire Guidinger
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
| | - Gina Williamson
- Counseling Psychology and Human Services, University of Oregon, United States; The Prevention Science Institute, University of Oregon, United States
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Wahesh E, Moreton A, McKechnie M. The Indirect Effect of Distress Tolerance on Young Adult Alcohol Use Behaviors via Coping Motives. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2020. [DOI: 10.1002/jaoc.12084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Edward Wahesh
- Department of Education and Counseling Villanova University
| | - Amanda Moreton
- Department of Education and Counseling Villanova University
- Now at The Lincoln Center for Family and Youth AudubonPennsylvania
| | - Megan McKechnie
- Department of Education and Counseling Villanova University
- Now at Merakey Behavioral Health Services PhiladelphiaPennsylvania
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Juarascio AS, Parker MN, Manasse SM, Barney JL, Wyckoff EP, Dochat C. An exploratory component analysis of emotion regulation strategies for improving emotion regulation and emotional eating. Appetite 2020; 150:104634. [DOI: 10.1016/j.appet.2020.104634] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 01/18/2023]
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Juarascio A, Manasse S, Clark KE, Schaumberg K, Kerrigan S, Goldstein SP, Evans BC, Wyckoff E, Murray HB, Felonis CR, Forman E. Understanding the overlap and differences in terms describing patterns of maladaptive avoidance and intolerance of negative emotional states. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2020.109859] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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10
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Brosof LC, Munn-Chernoff MA, Bulik CM, Baker JH. Associations between eating expectancies and Eating disorder symptoms in men and women. Appetite 2019; 141:104309. [PMID: 31170435 DOI: 10.1016/j.appet.2019.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 05/30/2019] [Accepted: 06/03/2019] [Indexed: 01/27/2023]
Abstract
Eating expectancies, or learned expectations that an individual has about eating, prospectively predict eating disorder (ED) symptoms. Most studies examining eating expectancies have focused on one or two eating expectancies and their relation with bulimic symptoms. In addition, these studies have been conducted mostly in women. Thus, it is unclear whether: 1) associations between eating expectancies and ED symptoms vary between men and women, and 2) extend to ED symptoms other than bulimic symptoms. The current study (N = 197 undergraduate men and 246 undergraduate women) investigated sex variance in a model of eating expectancies and ED symptoms, including factors associated with ED symptoms (i.e., negative urgency, negative affect, alcohol use, drug use, and body mass index). Sex variance was tested using path analysis in a model including eating expectancies and associated factors, with excessive exercise, negative attitudes toward obesity, restricting, cognitive restraint, binge eating, purging, muscle building, and body dissatisfaction as dependent variables. Unconstrained (i.e., unconstrained paths across men and women) and constrained (i.e., constraining paths across men and women) models were tested. The unconstrained and constrained models differed significantly, indicating that the models varied by sex. For both sexes, eating expectancies were uniquely associated with ED symptoms. For men, Eating Manages Negative Affect was significantly associated with the most ED symptoms. In contrast, for women, Eating Leads to Feeling Out of Control was associated with the most ED symptoms. Previous findings regarding eating expectancies and ED symptoms in women may not generalize to men. Intervening on eating expectancies in a sex-specific way may help reduce specific ED symptoms.
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Affiliation(s)
- Leigh C Brosof
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | | | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jessica H Baker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Thiel AM, Kilwein TM, De Young KP, Looby A. Differentiating motives for nonmedical prescription stimulant use by personality characteristics. Addict Behav 2019; 88:187-193. [PMID: 30223236 DOI: 10.1016/j.addbeh.2018.08.040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/07/2018] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
Nonmedical prescription stimulant use (NPS) is increasing, particularly among college students. College students typically engage in NPS for cognitive enhancement, recreational, and appetite/weight-related purposes; however, little research has used these motives to identify specific risk for, or consequences of, NPS. Moreover, there may be unique risk factors for motive-specific NPS that have yet to be explored, such as relevant personality traits (i.e., distress tolerance, impulsivity, and perfectionism) that are associated with NPS in general. Therefore, this study aimed to examine whether NPS users and nonusers could be differentiated via facets of impulsivity, perfectionism, and distress tolerance, and whether users could be further differentiated by reported motive for use based on these traits. Midwestern university undergraduate students (N = 668) who were enrolled in a psychology research pool completed an online survey assessing demographics, NPS and motives, and measures of distress tolerance, impulsivity, and perfectionism. Participants were primarily female (78%) and aged 18-54 (M = 20.10, SD = 3.19) years. Univariate and multivariate analysis of variance tests revealed associations between lifetime NPS and higher impulsivity, higher perfectionism, and lower distress tolerance. Further tests revealed NPS for appetite/weight-related purposes was associated with lower distress tolerance, while NPS for recreational purposes was associated with higher impulsivity. These findings contribute novel information regarding NPS motives and personality constructs. This information may aid in comprehensive identification of high-risk individuals for NPS and inform the development of specialized prevention and intervention efforts.
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12
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Ay R, Aytas O. The relationship between eating attitudes and distress tolerance in obsessive compulsive disorder. ARCH CLIN PSYCHIAT 2018. [DOI: 10.1590/0101-60830000000176] [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: 11/21/2022] Open
Affiliation(s)
- Rukiye Ay
- Malatya Training and Research Hospital, Turkey
| | - Ozgur Aytas
- Malatya Training and Research Hospital, Turkey
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13
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Kauffman BY, Bakhshaie J, Lam H, Alfano C, Zvolensky MJ. Insomnia and eating expectancies among college students: the role of emotion dysregulation. Cogn Behav Ther 2018; 47:470-481. [PMID: 29774791 DOI: 10.1080/16506073.2018.1466910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
There is limited understanding of the relation between insomnia and aspects of eating among college students though available data suggest salient clinical relationships. The present study explored a potential transdiagnostic mechanism in the relation between insomnia symptoms and eating expectancies. Participants were a racially/ethnically diverse sample of 1589 college students (80.4% females; Mage = 22.2 years, SD = 5.27) from an urban university. Primary analysis included three regression-based models of eating expectancies. Insomnia symptoms served as the predictor, and emotion dysregulation served as the indirect (mediator) variable in all models. Results indicated that insomnia symptoms yielded a significant indirect effect through emotion dysregulation on expectancies of eating to help manage negative affect, alleviate boredom, and lead to feeling out of control. Students experiencing insomnia symptoms may be at higher risk for experiencing dysregulated emotions and consequently maladaptive eating expectancies compared to good sleepers.
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Affiliation(s)
- Brooke Y Kauffman
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Jafar Bakhshaie
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Hantin Lam
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Candice Alfano
- a Department of Psychology , University of Houston , Houston , TX , USA
| | - Michael J Zvolensky
- a Department of Psychology , University of Houston , Houston , TX , USA.,b Department of Behavioral Sciences , University of Texas MD Anderson Cancer Center , Houston , TX , USA.,c Health Institute , University of Houston , Houston , TX , USA
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14
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Berenz EC, Vujanovic A, Rappaport LM, Kevorkian S, Gonzalez RE, Chowdhury N, Dutcher C, Dick DM, Kendler KS, Amstadter A. A Multimodal Study of Childhood Trauma and Distress Tolerance in Young Adulthood. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2018; 27:795-810. [PMID: 30636862 PMCID: PMC6329603 DOI: 10.1080/10926771.2017.1382636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Individuals with a history of childhood trauma experience deficits in emotion regulation. However, few studies have investigated childhood trauma and both perceived (i.e., self-report) and behavioral measures of distress tolerance. The current study evaluated associations between childhood trauma (i.e., physical abuse, sexual abuse, and witnessing family violence) and measures of perceived (Distress Tolerance Scale) and behavioral distress tolerance (i.e., Paced Auditory Serial Addition Test, breath-holding). Participants were 320 undergraduate students with a history of interpersonal trauma (e.g., sexual/physical assault). Structural equation modeling was used to evaluate associations between frequency of childhood trauma type and distress tolerance. Greater childhood physical abuse was associated with higher perceived distress tolerance. Greater levels of witnessing family violence were associated with lower behavioral distress tolerance on the breath-holding task. No significant effects were found for Paced Auditory Serial Addition Test performance. Associations between childhood trauma and emotion regulation likely are complex and warrant further study.
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Affiliation(s)
- Erin C. Berenz
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Anka Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Lance M. Rappaport
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Salpi Kevorkian
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | - Rose Emily Gonzalez
- Department of Pediatrics, University of Virginia, Charlottesville, Virginia, USA
| | - Nadia Chowdhury
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Christina Dutcher
- Department of Psychology, University of Texas at Austin, Austin, Texas, USA
| | - Danielle M. Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kenneth S. Kendler
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ananda Amstadter
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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15
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Elmquist J, Shorey RC, Anderson SE, Stuart GL. A preliminary investigation of the relationship between dispositional mindfulness and eating disorder symptoms among men in residential substance use treatment. ADDICTION RESEARCH & THEORY 2016; 25:67-73. [PMID: 29085258 PMCID: PMC5659606 DOI: 10.1080/16066359.2016.1198475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The comorbidity between eating disorders (EDs) and substance use disorders (SUDs) is of particular concern given the high rates of mortality, relapse and poor treatment outcomes associated with both disorders. As a result, there has been a growing impetus within the field to elucidate factors that might influence and aid treatment for this comorbidity. One such factor is dispositional mindfulness, as past literature has demonstrated a significant relationship between mindfulness and both EDs and SUDs. However, we are unaware of any research that has examined the relationship between dispositional mindfulness and ED symptoms in a sample of men in residential treatment for SUDs. Medical records from 152 men were included in the current study. Alcohol and drug use and problems, ED symptoms, and dispositional mindfulness were assessed with self-report measures. Hierarchical regression analysis indicated that dispositional mindfulness was inversely related to ED symptoms after controlling for alcohol use, drug use, and age. Although results are preliminary and continued research in this area is needed, our findings suggest that there may be potential usefulness in targeting and enhancing mindfulness among patients in residential treatment for SUDs with co-occurring psychiatric symptoms (e.g., EDs).
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Affiliation(s)
- JoAnna Elmquist
- University of Tennessee, Knoxville (Department of Psychology, 1404 Circle Drive, 204 Austin Peay Building, Knoxville, TN 37996)
| | - Ryan C Shorey
- Ohio University (Ohio University, Department of Psychology, 239 Porter Hall, Athens, Ohio 45701)
| | - Scott E Anderson
- Cornerstone of Recovery, Louisville, TN (1214 Topside Rd, Louisville, TN 37777)
| | - Gregory L Stuart
- University of Tennessee, Knoxville (Department of Psychology, 1404 Circle Drive, 204 Austin Peay Building, Knoxville, TN 37996)
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Juarascio AS, Felton JW, Borges AM, Manasse SM, Murray HB, Lejuez CW. An investigation of negative affect, reactivity, and distress tolerance as predictors of disordered eating attitudes across adolescence. J Adolesc 2016; 49:91-8. [PMID: 27018749 DOI: 10.1016/j.adolescence.2016.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/28/2016] [Accepted: 02/23/2016] [Indexed: 11/18/2022]
Abstract
The current study examined internalizing symptoms, affect reactivity, and distress intolerance as prospective predictors of increases in eating disorder (ED)-attitudes during adolescence. Adolescents (n = 206) took part in a six-year longitudinal study examining the development of psychopathology. Latent growth curve analysis was used to examine associations between predictors and later ED-attitudes. Distress intolerance and internalizing symptoms were associated with ED-attitudes at baseline, but did not predict increases over time. Affect reactivity, however, was significantly associated with increases in ED-attitudes over time. Baseline affect reactivity did not interact with baseline distress intolerance to predict increases in ED-attitudes; however higher baseline internalizing symptoms interacted with distress intolerance to predict increases in ED-attitudes across adolescence. These results are among the first to document that affect reactivity alone and the combined effect of high internalizing symptoms and high distress intolerance early in adolescence are risk factors for the later development of ED-attitudes.
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Affiliation(s)
| | - Julia W Felton
- University of Maryland, Department of Psychology, College Park, MD, USA
| | - Allison M Borges
- University of Maryland, Department of Psychology, College Park, MD, USA
| | | | - Helen B Murray
- Drexel University, Department of Psychology, Philadelphia, PA, USA
| | - Carl W Lejuez
- University of Maryland, Department of Psychology, College Park, MD, USA
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Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency. Drug Alcohol Depend 2015; 155:147-53. [PMID: 26278196 PMCID: PMC4581985 DOI: 10.1016/j.drugalcdep.2015.07.679] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/24/2015] [Accepted: 07/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) among inpatients with substance use disorders (SUDs) is associated with heightened engagement in a variety of risky, self-destructive, and health-compromising behaviors (e.g., risky sexual behavior, aggression). Extant research provides support for the role of emotion dysregulation in the PTSD-risky behavior relation among inpatients with SUD; however, this research has been limited by a focus on emotion dysregulation involving negative (versus positive) emotions. The goal of the current study was to extend past research on the PTSD-risky behavior relation by examining the potential mediating roles of negative and positive urgency (two domains of emotion dysregulation defined by the tendency to engage in risky behavior in the context of negative and positive emotions, respectively). METHODS Participants were 158 trauma-exposed inpatients with (n=91) and without (n=67) lifetime PTSD consecutively admitted to a residential SUD treatment facility (M age=34.34; 59.5% White, 50.6% female). Patients were administered diagnostic interviews and completed self-report questionnaires. RESULTS Significant positive associations were found among lifetime PTSD symptoms, negative and positive urgency, and risky behaviors. Moreover, findings revealed significant indirect effects of lifetime PTSD symptoms on risky behaviors through the pathways of both negative and positive urgency. CONCLUSIONS Results provide initial support for the mediating roles of both negative and positive urgency in the PTSD-risky behavior relation, highlighting the potential utility of teaching trauma-exposed inpatients with PTSD-SUD skills for tolerating negative and positive emotional states without engaging in maladaptive behaviors.
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Elmquist J, Shorey RC, Anderson S, Stuart GL. Eating Disorder Symptoms and Length of Stay in Residential Treatment for Substance Use: A Brief Report. J Dual Diagn 2015; 11:233-7. [PMID: 26457661 PMCID: PMC4724169 DOI: 10.1080/15504263.2015.1104480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Treatment dropout is common both among people in treatment for eating disorders and for substance use disorders. Because of the high rates of co-occurrence and mortality associated with these disorders, the purpose of the current study was to examine the relationship among eating disorder symptoms, length of stay, and decisions to leave against medical advice among individuals in substance use treatment. METHODS We analyzed de-identified medical record data for 122 adult women enrolled in residential treatment for substance use disorders over a 12-month period. Routine treatment intake included standardized assessments of eating disorders, depression, and substance use. RESULTS Participants averaged 43.1 years of age (SD = 10.7) and were primarily non-Hispanic Caucasian (n = 118, 96.7%). Approximately 8 (6.6%) patients met criteria for a probable eating disorder and 79 (64.8%) for a probable alcohol use disorder. Mean length of stay was 28.1 days (SD = 6.6) and 21 (17%) patients left against medical advice. Logistic regression analysis showed that eating disorder symptoms were significantly associated with decisions to leave treatment against medical advice after controlling for age, years of education, depression symptoms, alcohol problems, and drug problems: χ(2) = 14.88, df = 6, p =.02. This model accounted for 19.1% (Nagelkerke R(2)) of the variance in discharge type. Eating disorder symptoms were not associated with length of treatment. CONCLUSIONS Our findings suggest the importance of assessing and monitoring eating disorder symptoms among individuals in treatment for substance use disorders.
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Affiliation(s)
- JoAnna Elmquist
- a University of Tennessee-Knoxville , Knoxville , Tennessee , USA
| | - Ryan C Shorey
- b Department of Psychology , Ohio University , Athens , Ohio , USA
| | - Scott Anderson
- c Cornerstone of Recovery , Louisville , Tennessee , USA
| | - Gregory L Stuart
- a University of Tennessee-Knoxville , Knoxville , Tennessee , USA
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