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Palmier-Claus J, Golby R, Stokes LJ, Saville CWN, Velemis K, Varese F, Marwaha S, Tyler E, Taylor P. The relationship between childhood adversity and affective instability across psychiatric disorders: A meta-analysis. Acta Psychiatr Scand 2024. [PMID: 39128865 DOI: 10.1111/acps.13745] [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: 05/03/2024] [Revised: 07/22/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
INTRODUCTION Affective instability represents an important, transdiagnostic biobehavioural dimension of mental ill health and clinical outcome. The causes of affective instability remain unclear. This systematic review and meta-analysis evaluated the extent to which exposure to childhood adversity is associated with affective instability across psychiatric disorders, and which forms of adversity are most strongly associated with affective instability. METHODS The review followed a published protocol (PROSPERO: CRD42020168676). Searches in Medline, Embase and PsychInfo identified studies using quantitative measures of childhood adversity and affective instability, published between January 1980 and July 2023. Data were analysed using a random effects meta-analysis separately for each outcome, namely affective lability, emotion dysregulation, and rapid cycling. The Mixed-Methods Appraisal Tool was used to appraise the quality of the literature. RESULTS The search identified 36 studies involving 8431 participants. All reports focused on cross-sectional associations. We did not identify any prospective longitudinal research. The analysis showed small, but statistically significant effects of childhood adversity on affective lability (r = 0.09, 95% CI 0.02, 0.17), emotion dysregulation (r = 0.25, 95% CI 0.19, 0.32), and rapid cycling (OR = 1.39; 95% CI 1.14, 1.70). When considering adversity subtypes, emotional abuse showed the strongest effect on affective lability (r = 0.16, 95% CI 0.07, 0.24) and emotion dysregulation (r = 0.32, 95% CI 0.19, 0.44). Quality assessment scores were generally low. Most studies failed to control for confounding factors or offer assurances around the representativeness of the samples. CONCLUSIONS The findings suggest that childhood adversity, particularly emotional abuse, is associated emotional instability in adulthood, but further prospective longitudinal research is needed to confirm causality. The findings have implications for the prevention and treatment of affective instability across psychiatric disorders.
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Affiliation(s)
- Jasper Palmier-Claus
- Spectrum Centre for Mental Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
- Lancashire & South Cumbria NHS Foundation Trust, Preston, Lancashire, UK
| | - Rebecca Golby
- Lancashire & South Cumbria NHS Foundation Trust, Preston, Lancashire, UK
| | - Laura-Jean Stokes
- Psychology Department, Faculty of Science & Technology, Lancaster University, Lancaster, UK
| | | | - Kyriakos Velemis
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Filippo Varese
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham and Solihull Mental Health NHS Trust, Birmingham, UK
| | - Elizabeth Tyler
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
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Assim A, Kaminer D, Hogarth L, Magner-Parsons B, Seedat S. Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents. CHILD ABUSE & NEGLECT 2024; 154:106885. [PMID: 38850749 DOI: 10.1016/j.chiabu.2024.106885] [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: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts. OBJECTIVE The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents. PARTICIPANTS AND SETTING A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey. METHODS Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems. RESULTS CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives. CONCLUSIONS The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.
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Affiliation(s)
- Ayesha Assim
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa
| | - Debra Kaminer
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa.
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Bella Magner-Parsons
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Faculty of Medicine and Health Sciences, 241, Cape Town, South Africa
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Parks BJ, Salazar P, Morrison L, McGraw MK, Gunnell M, Tobacyk J, Brents LK, Berquist MD. Limited bedding and nesting increases ethanol drinking in female rats. Pharmacol Biochem Behav 2024; 239:173756. [PMID: 38555037 PMCID: PMC11088506 DOI: 10.1016/j.pbb.2024.173756] [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: 12/20/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
Prenatal opioid exposure (POE) and postnatal adverse experiences are early life adversities (ELA) that often co-occur and increase problematic alcohol (EtOH) drinking during adolescence. We investigated the relationship between POE, postnatal adversity, and adolescent EtOH drinking in rats. We also sought to determine whether ELAs affect alpha-adrenoceptor density in the brain because the noradrenergic system is involved in problematic alcohol drinking and its treatment. We hypothesized that the combination of POE and postnatal adversity will increase alcohol drinking in rats compared to rats with exposure to either adversity alone or to control. We also predicted that POE and postnatal adversity would increase α1-adrenoceptor density and decrease α2-adrenoceptor density in brain to confer a stress-responsive phenotype. Pregnant rats received morphine (15 mg/kg/day) or saline via subcutaneous minipumps from gestational day 9 until birth. Limited bedding and nesting (LBN) procedures were introduced from postnatal day (PD) 3-11 to mimic early life adversity-scarcity. Offspring rats (PD 31-33) were given opportunities to drink EtOH (20 %, v/v) using intermittent-access, two-bottle choice (with water) procedures. Rats given access to EtOH were assigned into sub-groups that were injected with either yohimbine (1 mg/kg, ip) or vehicle (2 % DMSO, ip) 30 min prior to each EtOH access session to determine the effects of α2-adrenoceptor inhibition on alcohol drinking. We harvested cortices, brainstems, and hypothalami from EtOH-naïve littermates on either PD 30 or PD 70 and conducted radioligand receptor binding assays to quantify α1- and α2-adrenoceptor densities. Contrary to our hypothesis, only LBN alone increased EtOH intake in female adolescent rats compared to female rats with POE. Neither POE nor LBN affected α1- or α2-adrenoceptor densities in the cortex, brainstem, or hypothalamus of early- or late-aged adolescent rats. These results suggest a complex interaction between ELA type and sex on alcohol drinking.
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Affiliation(s)
- B J Parks
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - P Salazar
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - L Morrison
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - M K McGraw
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - M Gunnell
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - J Tobacyk
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - L K Brents
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America
| | - M D Berquist
- Department of Pharmacology and Toxicology, College of Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 611, Little Rock, AR 72205, United States of America.
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Kirsch DE, Grodin EN, Nieto SJ, Kady A, Ray LA. Early life stress is associated with greater negative emotionality and peripheral inflammation in alcohol use disorder. Neuropsychopharmacology 2024:10.1038/s41386-024-01877-4. [PMID: 38740901 DOI: 10.1038/s41386-024-01877-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/16/2024]
Abstract
Early life stress (ELS) increases risk for psychiatric illness, including alcohol use disorder (AUD). Researchers have hypothesized that individuals with and without a history of ELS who have the same primary DSM-5 diagnosis are clinically and biologically distinct. While there is strong support for this hypothesis in the context of mood disorders, the hypothesis remains largely untested in the context of AUD. This study investigated the impact of ELS on the neuroclinical phenomenology and inflammatory profile of individuals with AUD. Treatment-seeking adults with AUD (N = 163) completed the Adverse Childhood Experiences (ACE) Questionnaire and phenotypic battery as part of a pharmacotherapy trial for AUD (NCT03594435). Participants were classified as having "no-ELS," (ACE = 0) "moderate-ELS," (ACE = 1, 2 or 3) or "high-ELS" (ACE = 4 + ). The Addictions Neuroclinical Assessment domains incentive salience and negative emotionality were derived and used to assess the neuroclinical phenomenology of AUD. We tested (1) cumulative ELS as a predictor of ANA domains and (2) ELS group differences in ANA domains. A subset of participants (N = 98) provided blood samples for a biomarker of peripheral inflammation (C-reactive protein; CRP); analyses were repeated with CRP as the outcome variable. Greater ELS predicted higher negative emotionality and elevated CRP, but not incentive salience. The high-ELS group exhibited greater negative emotionality compared with the no-ELS and moderate-ELS groups, with no difference between the latter two groups. The high-ELS group exhibited elevated CRP compared with the no/moderate-ELS group. Findings suggest that high-ELS exposure is associated with a unique AUD neuroclinical presentation marked by greater negative emotionality, and inflammatory profile characterized by elevated peripheral CRP.
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Affiliation(s)
- Dylan E Kirsch
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Erica N Grodin
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Steven J Nieto
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Annabel Kady
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Lara A Ray
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA.
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Zhong W, Liang Q, Yang A, Yan R. Why emotional neglect brings suicidal ideation? The mediating effect of meaning in life and the moderating effect of post-stress growth. CHILD ABUSE & NEGLECT 2024; 149:106700. [PMID: 38382400 DOI: 10.1016/j.chiabu.2024.106700] [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: 09/06/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Emotional neglect during childhood has long-lasting negative effects on individuals, and it is often hidden and unrecognized. Previous research has not fully understood its unique effects on mental health outcomes, especially when considering the co-occurrence with other forms of maltreatment. The meaning-making coping and growth model suggests that individuals achieve positive psychological outcomes by constructively integrating negative experiences into their self-concept, which may be a protective mechanism against the detrimental effects of emotional neglect. OBJECTIVE This study aimed to examine the relationship between emotional neglect and suicidal ideation among undergraduates, accounting for the presence of emotional abuse and physical neglect, and to investigate the mediating role of meaning in life and the moderating role of post-stress growth in this relationship. METHODS A self-reported survey was conducted with 3132 undergraduate students from a university in South China. The survey assessed emotional neglect, emotional abuse, physical neglect, suicidal ideation, post-stress growth, and meaning in life. RESULTS Meaning in life partially mediated the relationship between emotional neglect and suicidal ideation. Post-stress growth moderated the association between emotional neglect and the sense of meaning in life, in particular the moderation effect was stronger when emotional abuse was weaker. CONCLUSIONS Meaning in life mediated the relationship between emotional neglect and suicide ideation. Post-stress growth moderated the mediation effect such that it was weakened among individual with a higher level of post-stress growth. This study contributes to the understanding of the psychopathological processes following emotional neglect and the development of positive personal changes thereafter.
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Affiliation(s)
- Weiwei Zhong
- Mental Health Education and Consultation Center, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China
| | - Qianrong Liang
- School of Finance, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China; Institute of Analytical Psychology, Faculty of Humanities and Social Sciences, City University of Macau, Macau 999078, China
| | - An Yang
- Department of Applied Psychology, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China.
| | - Ru Yan
- Mental Health Education and Consultation Center, Guangdong University of Foreign Studies, Guangzhou, Guangdong 510420, China.
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McLean CL, Ruork AK, Ramaiya MK, Fruzzetti AE. Feasibility and initial impact of single-session internet-delivered acceptance vs change skills for emotions for stress- and trauma-related problems: a randomized controlled trial. Behav Cogn Psychother 2023; 51:443-458. [PMID: 37288653 DOI: 10.1017/s1352465823000206] [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] [Indexed: 06/09/2023]
Abstract
BACKGROUND Current psychological trauma-focused interventions have left a gap for individuals who may not be ready for trauma-focused treatment and/or who present with other forms of clinically significant distress, such as subthreshold post-traumatic stress disorder (PTSD). Emotion regulation is a possible transdiagnostic mechanism of change that may promote and maintain some of the varied mental health problems related to trauma exposure. AIMS This study examines the feasibility and initial impact of two brief emotion regulation skill trainings targeting different processes hypothesized to reduce trauma-related problems, compared with an active control. METHOD Subjects (n = 156) were randomized to receive one of three brief internet-based trainings: (1) skill training on accepting emotions, (2) skill training on changing emotions, or (3) stress psychoeducation (control). Participants completed measures of emotion regulation, mindfulness, and affect intensity 24 hours pre- and immediately post-training. RESULTS Results suggested that a brief internet-based skills training programme was feasible and acceptable, with 91.9% completing the training programme to which they were randomized. Results showed that participants in all conditions demonstrated significant decreases in emotion regulation problems over time; yet these improvements did not vary by condition. Participants in the Change condition with higher PTSD symptoms were significantly more likely to have greater increases in positive affect compared with those with lower PTSD symptoms. CONCLUSIONS Although the three conditions did not show different outcomes, all three brief internet-delivered trainings were feasible. Results provide direction for future studies to evaluate the delivery of emotion regulation skills in individuals with trauma-related distress.
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Affiliation(s)
- Caitlin L McLean
- University of Nevada Reno, Reno, NV89557, USA
- VA San Diego Healthcare System and University of California San Diego, San Diego, CA92161, USA
| | - Allison K Ruork
- University of Nevada Reno, Reno, NV89557, USA
- Rutgers, The State University of New Jersey, New Brunswick, NJ08901, USA
| | - Megan K Ramaiya
- University of California San Francisco, San Francisco, CA94143, USA
| | - Alan E Fruzzetti
- University of Nevada Reno, Reno, NV89557, USA
- McLean Hospital and Harvard Medical School, Belmont, MA02478, USA
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Perini I, Mayo LM, Capusan AJ, Paul ER, Yngve A, Kampe R, Gauffin E, Mazurka R, Ghafouri B, Stensson N, Asratian A, Hamilton JP, Kastbom Å, Gustafsson PA, Heilig M. Resilience to substance use disorder following childhood maltreatment: association with peripheral biomarkers of endocannabinoid function and neural indices of emotion regulation. Mol Psychiatry 2023; 28:2563-2571. [PMID: 37041416 PMCID: PMC10611562 DOI: 10.1038/s41380-023-02033-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/21/2023] [Accepted: 03/10/2023] [Indexed: 04/13/2023]
Abstract
Childhood maltreatment (CM) is a risk factor for substance use disorders (SUD) in adulthood. Understanding the mechanisms by which people are susceptible or resilient to developing SUD after exposure to CM is important for improving intervention. This case-control study investigated the impact of prospectively assessed CM on biomarkers of endocannabinoid function and emotion regulation in relation to the susceptibility or resilience to developing SUD. Four groups were defined across the dimensions of CM and lifetime SUD (N = 101 in total). After screening, participants completed two experimental sessions on separate days, aimed at assessing the behavioral, physiological, and neural mechanisms involved in emotion regulation. In the first session, participants engaged in tasks assessing biochemical (i.e., cortisol, endocannabinoids), behavioral, and psychophysiological indices of stress and affective reactivity. During the second session, the behavioral and brain mechanisms associated with emotion regulation and negative affect were investigated using magnetic resonance imaging. CM-exposed adults who did not develop SUD, operationally defined as resilient to developing SUD, had higher peripheral levels of the endocannabinoid anandamide at baseline and during stress exposure, compared to controls. Similarly, this group had increased activity in salience and emotion regulation regions in task-based measures of emotion regulation compared to controls, and CM-exposed adults with lifetime SUD. At rest, the resilient group also showed significantly greater negative connectivity between ventromedial prefrontal cortex and anterior insula compared to controls and CM-exposed adults with lifetime SUD. Collectively, these peripheral and central findings point to mechanisms of potential resilience to developing SUD after documented CM exposure.
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Affiliation(s)
- Irene Perini
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden.
| | - Leah M Mayo
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden.
| | - Andrea J Capusan
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Elisabeth R Paul
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
| | - Adam Yngve
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
| | - Robin Kampe
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
| | - Emelie Gauffin
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Raegan Mazurka
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Bijar Ghafouri
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Niclas Stensson
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Asratian
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - J Paul Hamilton
- Department of Biological and Medical Psychology University of Bergen, Bergen, Norway
| | - Åsa Kastbom
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Per A Gustafsson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Child and Adolescent Psychiatry, Linköping University, Linköping, Sweden
| | - Markus Heilig
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping, Sweden
- Department of Psychiatry, Linköping University Hospital, Linköping, Sweden
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Hitch AE, Brown JL, DiClemente RJ. Interpersonal abuse and alcohol use among African American young women: the mediating role of emotion dysregulation. J Ethn Subst Abuse 2023; 22:433-452. [PMID: 34339342 PMCID: PMC8807765 DOI: 10.1080/15332640.2021.1952130] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
African American women experience a high prevalence of alcohol-related consequences, and no studies have explicitly examined the associations among lifetime interpersonal abuse, emotion dysregulation, and alcohol-related outcomes during the critical period of young adulthood within this population. This study used baseline data from a sample of African American young women (N = 560) who use alcohol, aged 18 to 24, enrolled in an HIV prevention intervention trial to examine whether emotion dysregulation mediated the relation between lifetime history of abuse and problematic alcohol use. Further, we sought to examine whether there were potential differential levels of problematic alcohol use based on the number of abuse types experienced. Multiple regression analyses showed that exposure to two or more forms of abuse was associated with problematic alcohol use, β = .24, p < .001, and heavy alcohol consumption, β = .23, p < .001, whereas history of a single form was not. Indirect effects of both single and multiple forms of abuse on problematic alcohol use (95% confidence interval [CI] [.16, 1.02]; [.46, 1.64]) and heavy alcohol consumption (95% CI [.02, .26]; [.05, .45]) via emotion dysregulation severity were found. Abuse and emotion dysregulation were associated with frequency of alcohol use and binge drinking, but not typical amount consumed. Hazardous alcohol consumption was prevalent among this sample of African American young women who use alcohol. This study provides preliminary evidence that emotion dysregulation may be an important mechanism buttressing the association between lifetime history of interpersonal abuse and problematic alcohol use among African American young women who use alcohol.
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Affiliation(s)
- Anthony E. Hitch
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
| | - Jennifer L. Brown
- Department of Psychology, University of Cincinnati, 4150 Edwards One Center, Cincinnati, OH, 45221
- Addiction Sciences Division, Department of Psychiatry & Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299, Cincinnati, OH
- Center for Addiction Research, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45299
| | - Ralph J. DiClemente
- Department of Social and Behavioral Sciences, New York University, 715/719 Broadway, New York, NY, 10003
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Kim HK, Bruce J. Role of Risk Taking and Inhibitory Control in Alcohol Use Among Maltreated Adolescents and Nonmaltreated Adolescents. CHILD MALTREATMENT 2022; 27:615-625. [PMID: 34278833 PMCID: PMC11249043 DOI: 10.1177/10775595211031349] [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: 06/13/2023]
Abstract
Exposure to childhood maltreatment is a significant risk factor for the development and persistence of problematic alcohol use. The present study examined the role of risk taking and inhibitory control, key cognitive processes believed to govern behavioral regulation, as mechanisms that underlie the association between childhood maltreatment and the early stages of alcohol use. A sample of 129 maltreated adolescents and 102 socioeconomic status-matched, nonmaltreated adolescents and their parents completed three annual assessments, including computer-administered tasks and adolescent- and parent-report questionnaires, across ages 12-13 through 14-15 years. Childhood maltreatment was not directly associated with alcohol use in middle adolescence but was significantly associated with deficits in inhibitory control in early adolescence, which, in turn, led to significantly increased alcohol use in middle adolescence. Indeed, decreased inhibitory control was significant as a mediator, highlighting the salient role of this cognitive process in the early stages of alcohol use among maltreated adolescents.
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Affiliation(s)
- Hyoun K Kim
- Department of Child & Family Studies/Human Life & Innovation Design, 26721Yonsei University, Seoul, South Korea
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Pfluger V, Rohner SL, Eising CM, Maercker A, Thoma MV. Internalizing Mental Health Disorders and Emotion Regulation: A Comparative and Mediational Study of Older Adults With and Without a History of Complex Trauma Exposure. Front Psychol 2022; 13:820345. [PMID: 35814079 PMCID: PMC9260226 DOI: 10.3389/fpsyg.2022.820345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 05/17/2022] [Indexed: 12/04/2022] Open
Abstract
Individuals with complex trauma exposure (CTE) in early life (i.e., childhood/adolescence) are at heightened risk for developing problems in various domains of functioning. As such, CTE has repeatedly been linked to internalizing mental health disorders, such as depression and anxiety, as well as emotion dysregulation across the lifespan. While these correlates of CTE are comparatively well studied up to middle adulthood, they are insufficiently studied in older adulthood. Therefore, this study aimed to (a) compare Swiss older adults with and without a CTE history regarding current and lifetime internalizing mental health disorders and emotion regulation strategies; and (b) to examine the potential mediating role of emotion regulation in the mental health disparities between these groups. A total of N = 257 participants (age = 49-95 years; 46.3% female) were assessed in a retrospective, cross-sectional study, using two face-to-face interviews. The CTE group (n = 161; M age = 69.66 years, 48.4% female) presented with significantly more current and lifetime internalizing mental health disorders than the non-affected (nCTE) group (n = 96; M age = 72.49 years, 42.7% female). The CTE group showed significantly higher emotion suppression and lower emotion reappraisal compared to the nCTE group. Mediation analysis revealed that the two emotion regulation strategies were significant mediators between CTE history and internalizing mental health disorders. Findings emphasize the relevance of emotion (dys-)regulation in understanding mental health disparities in older age and deciding about treatment strategies. Research and practice should pay more attention to the needs of this high-risk group of older individuals.
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Affiliation(s)
- Viviane Pfluger
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Shauna L. Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Carla M. Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
| | - Myriam V. Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zurich, Zurich, Switzerland
- University Research Priority Program Dynamics of Healthy Ageing, University of Zurich, Zurich, Switzerland
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11
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Weiss NH, Kiefer R, Goncharenko S, Raudales AM, Forkus SR, Schick MR, Contractor AA. Emotion regulation and substance use: A meta-analysis. Drug Alcohol Depend 2022; 230:109131. [PMID: 34864568 PMCID: PMC8714680 DOI: 10.1016/j.drugalcdep.2021.109131] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 01/03/2023]
Abstract
There has been exponential growth in research on emotion regulation and substance use in the past decade. The current meta-analysis evaluated variability in the magnitude of the relation between aspects of emotion regulation and substance use. A search of PsycINFO, Embase, PubMed, CINAHL Plus, and PILOTS in December 2020 resulted in 6642 initial studies, of which 95 met inclusion criteria (association between emotion regulation and substance use was reported, participants were > 18 years old, article was in English). A total of 445 effects were obtained (N = 156,025 participants; weighted Mage = 29.31; 59.5% female; 66.1% White; 76.6% non-clinical). Emotion regulation and substance use were significantly related (r = 0.19; p < 0.001; 95%CI [0.17, 0.20]). Emotion regulation abilities were generally more strongly related to substance use than emotion regulation strategies; this pattern was stronger for behavioral vs. cognitive abilities and extended to both negative and positive emotions. Relations were stronger for older and clinical samples; mixed effects were found for sex and no conclusive effects were found for race. Despite limitations of the existing literature (e.g., cross-sectional, self-reports), results indicated that the magnitude of the relation between emotion regulation and substance use varied considerably as a function of emotion regulation and substance use constructs and sample characteristics.
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12
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Nazligül MD, Yilmaz AE, Griffiths MD. Gaming Addiction and Exercise Addiction: To What Extent Are They The Same or Different In Terms of Emotional Abuse and/or Emotional Neglect Etiologies? Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00585-0] [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: 11/27/2022] Open
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13
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Monzer N, Hartmann M, Buckert M, Wolff K, Nawroth P, Kopf S, Kender Z, Friederich HC, Wild B. Associations of Childhood Neglect With the ACTH and Plasma Cortisol Stress Response in Patients With Type 2 Diabetes. Front Psychiatry 2021; 12:679693. [PMID: 34220585 PMCID: PMC8247465 DOI: 10.3389/fpsyt.2021.679693] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/25/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Cross-sectional as well as longitudinal studies have linked childhood maltreatment to type 2 diabetes in adulthood with childhood neglect showing the strongest effect on type 2 diabetes risk. However, the mechanisms that link childhood maltreatment to type 2 diabetes are still unclear. Alterations in the psychological and physiological stress response system, specifically the hypothalamus-pituitary-adrenal (HPA) axis are a common finding in samples with a background of childhood neglect and are associated with type 2 diabetes. In the present study, we investigated the association between childhood neglect and the physiological and psychological stress response in patients with type 2 diabetes and healthy control participants. Method: We assessed emotional and physical childhood neglect in a sample of n = 74 patients with type 2 diabetes and n = 50 healthy control participants. We used the trier social stress test (TSST) to induce a stress response. Blood ACTH and cortisol levels were measured before (T0), directly after (T1) as well as 30 (T2) and 60 (T3) min after the TSST. Participants' subjective experience was assessed via visual analog scales before, directly after as well as at 45 min after the TSST. We used multiple regression analyses to predict the change in self-reported tension between T0 and T1. Multilevel models were applied to predict cortisol and ACTH levels across all measurement points. Results: We found a significant association between moderate to severe childhood neglect and a stronger psychological stress response in patients with type 2 diabetes, that was not present in healthy controls. In type 2 diabetes patients, but not in healthy controls, higher ACTH levels across all measurement points were significantly associated with higher severity of emotional neglect and higher severity of physical neglect was significantly associated with a stronger increase in plasma cortisol from T0 to T1. Conclusions: This is the first study to investigate whether childhood maltreatment in patients with type 2 diabetes could be associated with a dysregulated stress response. Our results show a link between the psychological and physiological stress response and childhood neglect in type 2 diabetes patients. This pathway is thus a possible mechanism connecting type 2 diabetes and childhood neglect.
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Affiliation(s)
- Nelly Monzer
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Mechthild Hartmann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Magdalena Buckert
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Kira Wolff
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Nawroth
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany.,German Center for Diabetes Research (DZD), Heidelberg, Germany
| | - Stefan Kopf
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany.,German Center for Diabetes Research (DZD), Heidelberg, Germany
| | - Zoltan Kender
- Department of Medicine I and Clinical Chemistry, University Hospital Heidelberg, Heidelberg, Germany.,German Center for Diabetes Research (DZD), Heidelberg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Beate Wild
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
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Wang L, An CX, Song M, Li N, Gao YY, Zhao XC, Yu LL, Wang YM, Wang XY. Evaluation of childhood traumatic experience as a risk factor for alcohol use disorder in adulthood. BMC Psychiatry 2020; 20:15. [PMID: 31918691 PMCID: PMC6953234 DOI: 10.1186/s12888-020-2428-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 01/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to investigate the effect of early-age (prenatal, infant, and childhood) trauma on adulthood alcohol use disorder. METHODS A total number of 1534 subjects who were born and live in the city of Tangshan were selected. The subjects were divided into three age groups. General demographic data, conditions of the mothers during pregnancy, and condition of the babies at birth, were collected. The diagnosis of alcohol use disorder was based on Structured Clinical Interviews for DSM-IV Axis Disorders (patient version) (SCID). The childhood trauma questionnaire short form (CTQ-SF) [1] and the Lifetime of Experience Questionnaire (LTE-Q) [2] were used to evaluate stress in childhood and adulthood, respectively. RESULTS Only male subjects were diagnosed with lifelong alcohol abuse and alcohol dependence. There was no statistically significant difference in the prevalence of lifetime alcohol use disorder (X2 = 4.480, P = 0.345), current alcohol abuse, and current alcohol dependence among the three groups (X2abuse = 2.177, X2depedence = 2.198, P > 0.05). However, higher prevalence of lifetime alcohol use disorders was found in group with higher scores of CTQ (X2 = 9.315, P = 0.009), emotional abuse (X2 = 8.025, P = 0.018), physical abuse (X2 = 20.4080, P < 0.001), but not in the group with higher scores of emotional neglect (X2 = 1.226, P = 0.542), sexual abuse (X2 = 2.779, P = 0.249), physical neglect (X2 = 3.978, P = 0.137), LTE-Q (X2 = 5.415, P = 0.067), and PSQI (X2 = 5.238, P = 0.073). Protective factor for alcohol abuse for men was identified to be heavy drinking (OR = 0.085, 95%CI: 0.011-0.661), and the risk factors for alcohol abuse were identified to be frequent drinking (OR = 2.736, 95%CI: 1.500, 4.988), and consumption of low liquor (OR = 2.563, 95%CI: 1.387, 4.734). Risk factors for alcohol dependence in males were identified to be consumption of low liquor (OR = 5.501, 95%CI: 2.004, 15.103), frequent drinking (OR = 2.680, 95%CI: 1.164, 6.170), and childhood physical abuse (OR = 2.310, 95% CI: 1.026, 5.201). CONCLUSION Traumatic experience during infant and prenatal periods does not have a strong statistical correlation with alcohol use disorders for male adults. However, subjects with high CTQ scores, experience of emotional abuse and physical abuse show a statistically higher prevalence of lifetime alcohol use disorders. Several risk factors including consumption of low liquor, frequent drinking, and childhood physical abuse contribute to alcohol dependence in male adults.
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Affiliation(s)
- Lan Wang
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Cui-Xia An
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Mei Song
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Na Li
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Yuan-Yuan Gao
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Xiao-Chuan Zhao
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Lu-Lu Yu
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Yu-Mei Wang
- grid.452458.aDepartment of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031 China ,0000 0004 1760 8442grid.256883.2The Mental Health Institute of Hebei Medical University, Shijiazhuang, China ,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China
| | - Xue-Yi Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang, 050031, China. .,The Mental Health Institute of Hebei Medical University, Shijiazhuang, China. .,Hebei Brain Ageing and Cognitive Neuroscience Laboratory, Shijiazhuang, China.
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15
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Zaorska J, Kopera M, Trucco EM, Suszek H, Kobyliński P, Jakubczyk A. Childhood Trauma, Emotion Regulation, and Pain in Individuals With Alcohol Use Disorder. Front Psychiatry 2020; 11:554150. [PMID: 33192667 PMCID: PMC7661433 DOI: 10.3389/fpsyt.2020.554150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction: Several studies have confirmed that the experience of childhood trauma, poor emotion regulation, as well as the experience of physical pain may contribute to the development and poor treatment outcomes of alcohol use disorder (AUD). However, little is known about how the joint impact of these experiences may contribute to AUD. Objectives: To analyze associations between childhood trauma, emotion regulation, and pain in individuals with AUD. Methods: The study sample included 165 individuals diagnosed with AUD. The Childhood Trauma Questionnaire (CTQ) was used to investigate different types of trauma during childhood (physical, emotional, and sexual abuse and neglect), the Brief Symptom Inventory was used to assess anxiety symptoms, the Difficulties in Emotion Regulation Scale (DERS) was used to assess emotional dysregulation, and the Pain Resilience Scale and Pain Sensitivity Questionnaire were used to measure self-reported pain tolerance and sensitivity. Results: Childhood emotional abuse (CTQ subscale score) was positively associated with anxiety, anxiety was positively associated with emotional dysregulation, and emotional dysregulation was negatively associated with pain tolerance. Accordingly, there was support for a significant indirect negative association between childhood emotional abuse and pain tolerance. The serial mediation statistical procedure demonstrated that anxiety and emotional dysregulation mediated the effect of childhood emotional abuse on pain resilience among individuals with AUD. Conclusions: Targeting emotional dysregulation and physical pain that can result from childhood trauma may have particular therapeutic utility among individuals treated for AUD.
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Affiliation(s)
- Justyna Zaorska
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Kopera
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Elisa M Trucco
- Department of Psychology and the Center for Children and Families, Florida International University, Miami, FL, United States.,Department of Psychiatry, Addiction Center, University of Michigan, Ann Arbor, MI, United States
| | - Hubert Suszek
- Department of Psychology, University of Warsaw, Warsaw, Poland
| | - Paweł Kobyliński
- Laboratory of Interactive Technologies, National Information Processing Institute, Warsaw, Poland
| | - Andrzej Jakubczyk
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
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Khosravani V, Samimi Ardestani SM, Sharifi Bastan F, Mohammadzadeh A, Amirinezhad A. Childhood maltreatment, cognitive emotion regulation strategies, and alcohol craving and dependence in alcohol-dependent males: Direct and indirect pathways. CHILD ABUSE & NEGLECT 2019; 98:104197. [PMID: 31600610 DOI: 10.1016/j.chiabu.2019.104197] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 09/14/2019] [Accepted: 09/17/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Childhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence. METHODS In a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II). RESULTS Participants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence. CONCLUSIONS Although drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Ali Amirinezhad
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
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The role of emotion dysregulation in the relation of childhood trauma to heroin craving in individuals with heroin dependence. Drug Alcohol Depend 2019; 195:132-139. [PMID: 30634108 DOI: 10.1016/j.drugalcdep.2018.12.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/02/2018] [Accepted: 12/11/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Difficulties in emotion regulation (DER) may be important in heroin craving in individuals with heroin dependence who have experienced childhood trauma (CT). However, no research has been performed on DER in the context of heroin dependence. The aim of this study was to evaluate direct and indirect relations of CT to the subscales of heroin craving (i.e., heroin thoughts and interference, intention to use heroin and control of its consumption, and resistance to thoughts and decisions to use heroin) via DER dimensions in individuals with a DSM diagnosis of heroin dependence. METHODS In a cross-sectional design, 330 males with heroin dependence completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Difficulties in Emotion Regulation Scale (DERS), the Obsessive-Compulsive Drug Use Scale-Form Heroin (OCDUS-Form Heroin), and the Depression Anxiety Stress Scales (DASS). RESULTS The results revealed that CT had no direct relations to the subscales of heroin craving, but it indirectly was related to all three subscales of heroin craving via one of the DER dimensions named limited access to emotion regulation strategies (Strategies) after adjusting for demographic and clinical factors. CONCLUSIONS The findings suggest that Strategies may be related to heroin craving in individuals with heroin dependence who have CT. This proposes that treatment and prevention attempts focused on training the use of effective emotion regulation strategies may be useful to reduce heroin craving in individuals with heroin dependence who have experienced a history of CT.
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