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Maylott SE, Reese SE, Zhou AM, Kaliush PR, Terrell S, Saenz C, Brown L, Crowell SE, Lester B, Smid MC, Shakib JH, Garland EL, Conradt E. Maternal psychophysiology profiles: associations with prenatal opioid use, maternal emotion dysregulation, and newborn neurobehavior. Pediatr Res 2024:10.1038/s41390-024-03399-7. [PMID: 39097654 DOI: 10.1038/s41390-024-03399-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/05/2024] [Accepted: 07/01/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Opioid use among pregnant women has more than quadrupled over the past 20 years; however, comorbid risk factors such as emotion dysregulation confound the developmental consequences of prenatal opioid use. Maternal respiratory sinus arrhythmia (RSA) may help to disentangle the comorbid risk factors of prenatal emotion dysregulation and substance use and isolate their consequences on newborn neurobehavior. METHODS We examined maternal RSA in response to a mild, infant-related stress task in pregnant people (N = 192; 30 on medications for opioid use disorder) recruited from hospitals and a specialty prenatal clinic for substance use disorder. RESULTS Three latent profiles emerged based on maternal RSA reactivity. Mothers with RSA increasing (Profile 3; more nervous system dysregulation) had higher levels of emotion dysregulation than mothers with RSA decreasing (Profile 1; well-regulated nervous system responses) but were not more likely to use opioids. Additionally, RSA profiles were associated with newborn neurobehavior, including attention, regulation, handling, and arousal. CONCLUSIONS Given the variability in opioid use across RSA profiles and profile associations with newborn neurodevelopment, future studies should examine protective factors in pregnant individuals using opioids who show more flexible RSA responses. IMPACT Our study examined maternal psychophysiology and newborn outcomes in a unique population with high levels of emotion dysregulation and opioid use. Three profiles of maternal respiratory sinus arrythmia (RSA) reactivity were identified during pregnancy: decreasing, blunted, and increasing. The RSA increasing and blunted profiles were associated with higher emotion dysregulation than the decreasing profile. Most pregnant people on medications for opioid use disorder (65%) were grouped into the blunted profile, suggesting they might be more at risk for dysregulated RSA reactivity. Differences in RSA profiles were associated with newborn outcomes, with increasing and blunted RSA predicting more newborn neurobehavioral dysregulation.
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Affiliation(s)
- Sarah E Maylott
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
| | - Sarah E Reese
- University of Montana, School of Social Work, Missoula, MT, USA
| | - Anna M Zhou
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Parisa R Kaliush
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Sarah Terrell
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA, USA
| | - Celine Saenz
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Lydia Brown
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Barry Lester
- Departments of Psychiatry and Pediatrics, Center for the Study of Children at Risk, Alpert Medical School of Brown University and Women and Infants Hospital, Providence, RI, USA
| | - Marcela C Smid
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Julie H Shakib
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Eric L Garland
- University of Utah, College of Social Work, Salt Lake City, UT, USA
| | - Elisabeth Conradt
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
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Buckner JD, Vargo LA, Thomas KL. The relations of difficulties in emotion regulation and distress intolerance with cannabis problems: The role of protective behavioral strategies underutilization. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024:209462. [PMID: 39059769 DOI: 10.1016/j.josat.2024.209462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/28/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
INTRODUCTION Difficulties with emotion regulation and distress tolerance are related to more cannabis problems, yet little research has identified why this is the case. Cannabis-related protective behavioral strategies (PBS; behaviors used to mitigate cannabis related problems) are related to less cannabis consumption and related problems. Potentially, these individuals may use cannabis to alleviate the distress and/or in an attempt to regulate their emotions. Thus, the present study aimed to examine the mediational role of PBS on the relations of emotion dysregulation and distress intolerance with cannabis problems. METHODS Undergraduate students who endorsed past-month cannabis use (N = 339, Mage = 19.33, SDage = 1.37; 77.9 % female) at a southern United States university completed a survey online via Qualtrics. RESULTS More emotion dysregulation and less distress tolerance predicted less PBS use and more cannabis problems, but not cannabis use frequency. After statistically controlling for sex, the relation of each transdiagnostic factor with cannabis problems occurred indirectly via the relations of less PBS use and greater cannabis use frequency CONCLUSIONS: The present study supports previous claims that emotion dysregulation and distress intolerance are related to more cannabis problems. Additionally, results suggest that individuals with high levels of these problems underutilize PBS which, in turn, is associated with more frequent cannabis use and use-related problems. Clinical implications are discussed.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| | - Luke A Vargo
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Katharine L Thomas
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
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Mansueto G, Palmieri S, Sassaroli S, Ruggiero GM, Caselli G, Calligaro D, Manigrasso A, Nikčevic A, Spada MM. Emotion dysregulation in participants with substance use disorders: A metacognitive perspective. J Affect Disord 2024; 363:63-71. [PMID: 39038617 DOI: 10.1016/j.jad.2024.07.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/24/2024] [Accepted: 07/17/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Using the metacognitive model of emotion dysregulation as a basis, this study explored whether, among participants with substance use disorders (SUDs), metacognitive beliefs and repetitive negative thinking were associated with emotion dysregulation. METHODS 127 participants with SUDs and 127 controls without SUDs were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, and depression were assessed. t-tests, Mann-Whitney tests, logistic regression, correlation, and hierarchal regression analyses were run. RESULTS Participants with SUDs reported significantly higher levels of emotion dysregulation, positive beliefs about worry, beliefs about the need to control thoughts, rumination, and worry, compared to controls without SUDs. Among participants with SUDs negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, beliefs about the need to control thoughts, rumination, and worry were significantly associated with an increase of emotion dysregulation. LIMITATIONS The cross-sectional design. CONCLUSION Emotion dysregulation, metacognitive beliefs, and repetitive negative thinking may contribute to increase the risk of substance use. Among participants with SUDs emotion dysregulation is associated with the tendency to endorse dysfunctional metacognitive beliefs and report repetitive negative thinking. Metacognitive beliefs and repetitive negative thinking could be a suitable therapeutic target to reduce emotion dysregulation among participants with SUDs.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy; School of Applied Sciences, London South Bank University, London, UK.
| | - Sara Palmieri
- School of Applied Sciences, London South Bank University, London, UK; Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Sandra Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Gabriele Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Dalila Calligaro
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Antonella Manigrasso
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Ana Nikčevic
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Kingston upon Thames, UK
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Chang YC, Rubey RL, Ladd BO. Brief emotion regulation strategies to reduce alcohol craving: Mediating role of state difficulties in emotion regulation. Behav Res Ther 2024; 177:104527. [PMID: 38581778 DOI: 10.1016/j.brat.2024.104527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 03/13/2024] [Accepted: 03/27/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE This study experimentally compared the effects of emotion regulation (ER) strategies on alcohol craving and examined the mediating effect of state difficulties in emotion regulation (S-DER) on the relationship between negative/positive emotion and alcohol craving. METHOD 417 participants (76.74% women, Mage = 20.76 years) endorsing past-month heavy/binge drinking were randomly assigned to one of four ER conditions (positive reappraisal, distancing, distraction, and acceptance). Participants completed state assessments, including negative/positive emotion, S-DER, and alcohol craving, prior to (T0) and after (T1) engaging in a negative emotion induction task. Subsequently, participants completed an ER strategy task based on their assigned ER strategy condition and completed a third state assessment (T2). RESULTS Time had a significant quadratic effect on alcohol craving, such that craving increased from T0 to T1 and decreased from T1 to T2. There was no significant effect of ER strategy condition on craving. Change in S-DER mediated the relationship between the change in negative/positive emotion and the change in craving, with emotional modulation and emotional acceptance facets of S-DER dominating the mediating effect during negative emotion induction and ER strategy induction, respectively. CONCLUSIONS Results suggest interventions targeting S-DER's emotional modulation and acceptance facets could reduce acute craving when experiencing undesired emotions.
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Gallagher C, Brunelle C. Interpersonal Trauma and Substance Use Severity: The Serial Mediation of Emotional Intolerance and Emotional Dysregulation. J Trauma Dissociation 2024; 25:379-393. [PMID: 38095572 DOI: 10.1080/15299732.2023.2293777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/07/2023] [Indexed: 03/16/2024]
Abstract
Substance use is highly prevalent in those with trauma histories, especially in women, which may be in part explained by high rates of interpersonal trauma in this population. Research examining the potential mechanisms underlying the relationship between co-occurring interpersonal trauma histories and substance use disorders (SUDs) is in its infancy. The current study examined whether the relationship between interpersonal trauma and SUD severity could be understood via the sequential ordering of two transdiagnostic emotional vulnerability factors: 1) emotional intolerance (anxiety sensitivity, distress intolerance), and 2) emotional dysregulation (negative urgency, lack of clarity, nonacceptance, limited strategies, difficulties with goal-directed behavior). A sample of 130 adult community-based women self-identifying as experiencing substance use problems completed the online survey. Mediation analyses suggest that as women's lifetime interpersonal trauma increases, so does their SUD severity by way of emotional intolerance and subsequent difficulties regulating their emotions. The findings suggests that transdiagnostic interventions targeting tolerance of aversive emotions may facilitate the ability to learn and employ healthy emotion regulation strategies among women with interpersonal trauma histories and SUDs.
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Affiliation(s)
- C Gallagher
- Department of Psychology, University of New Brunswick, Fredericton, NB, Canada
| | - C Brunelle
- Department of Psychology, University of New Brunswick, Fredericton, Canada
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Di Nicola M, Pepe M, Montanari S, Marcelli I, Panaccione I, Janiri D, Janiri L, Sani G. Childhood sexual abuse and suicide attempts in patients with substance use disorders: The mediating role of emotion dysregulation. CHILD ABUSE & NEGLECT 2024; 151:106731. [PMID: 38507922 DOI: 10.1016/j.chiabu.2024.106731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 02/19/2024] [Accepted: 03/02/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Suicide attempts (SA) are a public health concern because of increasing prevalence and clinical implications. Childhood trauma (CT) and emotion dysregulation (ED) have been proposed as predictors of SA, but few data are available in patients with Substance Use Disorder (SUD). OBJECTIVE Our study aims to investigate the association of sociodemographic/clinical variables, CT typologies, and ED features with SA in SUD patients. PARTICIPANTS AND SETTING Subjects with SUD were screened in an outpatient setting. The final sample consisted of 226 patients, subdivided according to the presence of lifetime SA (SUD, n = 163 vs. SUD-SA, n = 63). METHODS Participants were compared for sociodemographic and clinical information. CT and ED were assessed through the Childhood Trauma Questionnaire - Short Form (CTQ-SF) and the Difficulties in Emotion Regulation Scale (DERS), respectively. We performed a mediation analysis to test the effect of CT and ED on SA. RESULTS Patients with a history of SA (27.9 %) displayed more psychiatric comorbidities (p = 0.002) and hospitalizations (p < 0.001), higher scores at CTQ-SF sexual abuse (p < 0.001) and DERS 'impulse' (p = 0.002), 'goals', 'non-acceptance', 'strategies' (p < 0.001) subscales. The relationship between CTQ-SF sexual abuse and SA was significantly mediated by DERS 'strategies' (p = 0.04; bootstrapped 95 % LLCI-ULCI = 0.004-0.024). CONCLUSIONS CT and different dimensions of ED were associated with SA in SUD patients. In our sample, the effects of childhood sexual abuse on SA were mediated by limited access to emotion regulation strategies. SUD patients are burdened with higher all-cause mortality, and CT and lifetime SA can worsen clinical outcomes. Clarifying the reciprocal interactions of psychopathological dimensions may help deliver targeted interventions and reduce suicide risk in specific populations.
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Affiliation(s)
- Marco Di Nicola
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy.
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Silvia Montanari
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Ilaria Marcelli
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | | | - Delfina Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy
| | - Luigi Janiri
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
| | - Gabriele Sani
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go Agostino Gemelli 8, 00168 Rome, Italy; Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go Francesco Vito 1, 00168 Rome, Italy
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7
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Waite EE, Raudales AM, Newberger NG, Ferguson JJ, Denning DM, Huffman S, Weiss NH, Dixon-Gordon KL. Longitudinal examination of borderline personality disorder symptoms and drug use: The influence of negative and positive emotion dysregulation. Personal Ment Health 2024; 18:157-165. [PMID: 38378990 PMCID: PMC11068492 DOI: 10.1002/pmh.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/13/2023] [Accepted: 01/02/2024] [Indexed: 02/22/2024]
Abstract
Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1 year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.
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Affiliation(s)
- Elinor E. Waite
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Alexa M. Raudales
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | - Noam G. Newberger
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | | | - Dominic M. Denning
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Sarah Huffman
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI USA
| | - Katherine L. Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA USA
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Tate M, Sinha R, Wemm S. Cumulative adversity and emotion dysregulation effects on suicidal ideation and attempts in a community sample. J Psychiatr Res 2024; 170:277-282. [PMID: 38183699 DOI: 10.1016/j.jpsychires.2023.12.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/08/2024]
Abstract
Adversity, trauma, and emotion dysregulation are commonly cited risk factors for suicidal thoughts and behaviors. Thus, the role of these factors in conferring risk for suicidal ideation (SI) and suicide attempts (SA) amongst community adults was assessed. A cross-sectional cohort-based study with community adults (n=757; female=55.0%) assessed emotion dysregulation, cumulative adversity including highly stressful and traumatic events, as well as other known risk factors for suicidality (e.g., self-reported depression and anxiety history) to predict a lifetime history of SI or SA, SI but no SA, or SI and SA. Higher cumulative stress and trauma scores conferred risk for SI, specifically on the subscales major life events, recent life events, and chronic stressors. Higher emotion dysregulation was associated with an increased risk for a SA relative to no SI or SA, particularly nonacceptance of emotional responses. Lifetime trauma was the only predictor of SA relative to SI. Nonacceptance of emotions significantly mediated the association between life traumas and suicidality. Cumulative adversity and emotion dysregulation confer risk for suicidal ideation and attempts, and higher lifetime trauma predicted attempts over ideation. These findings suggest that targeting emotion dysregulation, and specifically nonacceptance of difficult emotions, may be a useful strategy in reducing suicidal behaviors in individuals with trauma history and concurrent suicidal ideation.
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Affiliation(s)
- Marshall Tate
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA
| | - Stephanie Wemm
- Department of Psychiatry, Yale School of Medicine, 2 Church Street South, Suite 209, New Haven, CT, 06519, USA.
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Sakulsriprasert C, Thawornwutichat R, Phukao D, Guadamuz TE. Early maladaptive schemas and addictive behaviours: A systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:1416-1432. [PMID: 37464912 DOI: 10.1002/cpp.2882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 06/08/2023] [Accepted: 06/26/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Recently, early maladaptive schemas have been increasingly focused as the underlying factor of several psychopathologies. The primary objective is to systematically review and meta-analytically analyse the evidence on the relationship between early maladaptive schemas and types of addictive behaviours. Additionally, the secondary objective was to examine potential moderators of the effect sizes. METHODS The systematic search was conducted on three databases including 'Scopus', 'Web of Science' and 'PubMed'. They were searched for quantitative studies investigating the relationship between early maladaptive schemas and addictive behaviours. The studies that were non-English and had insufficient information to calculate effect sizes were excluded. The random-effect model was utilized to estimate the pool effect sizes, and the meta-regression was used for moderation analysis. RESULTS Thirty-three studies with 12,577 participants were included for analyses. Most of included studies were conducted in the United States (k = 12, 36.36%). The mean ages of participants varied from 13.32 to 46.09 years. The findings indicated that all of early maladaptive schemas and schema domains positively correlated with addictive behaviours. The disconnection and rejection, impaired limits and impaired autonomy were the domains with the highest association with substance addictions (pool r = 0.338, 3.26 and 3.16, respectively). Furthermore, disconnection and rejection and impaired autonomy were the schema domains with the highest association with behavioural addictions (0.310 and 0.304, respectively). The moderation analysis demonstrated that study design was the factor affecting the effect sizes between schema domain and addictive behaviours. LIMITATION All included studies were from peer-reviewed journals in English. Moreover, the number of research examining the relationship between early maladaptive schemas and behavioural addictions was limited. CONCLUSION The findings provide evidence supporting the idea that substance addictions and behavioural addictions have shared risk factors, supporting the validity of the schema model, which can be applied for targeting and preventing addictive behaviours.
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Affiliation(s)
- Chaiyun Sakulsriprasert
- Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand
| | - Ratipan Thawornwutichat
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Darunee Phukao
- Department of Health Social Science, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Thomas E Guadamuz
- Center of Excellence in Research on Gender, Sexuality and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
- John F. Kennedy School of Government, Harvard University, Cambridge, Massachusetts, USA
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McCool MW, Mochrie KD, Lothes JE, Guendner E, St. John J, Noel NE. Drug use and suicidal ideation in the daily lives of individuals in a dialectical behavior therapy program. J Clin Psychol 2023; 79:2556-2565. [PMID: 37462923 PMCID: PMC10592253 DOI: 10.1002/jclp.23564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/07/2023] [Accepted: 06/29/2023] [Indexed: 10/12/2023]
Abstract
OBJECTIVES Substance use disorders and borderline personality disorders (BPD) often co-occur and may be concurrently treated by Dialectical Behavior Therapy (DBT). However, there is limited information on how drug use and suicidal ideation may interact in the daily lives of individuals receiving DBT treatment. METHODS This study examined the DBT diary cards of 47 individuals in a community mental health center's partial hospital and intensive outpatient program. Multilevel modeling techniques were used to examine the moderating effects of BPD symptom severity on the relationship between same day, 1-, 2-, and 3-day lagged drug use and suicidal ideation. RESULTS Results indicated a significant relationship between same-day, 1-day lagged, 2-day lagged drug use and suicidal ideation. BPD was a moderator for the relationship between 1-day lagged drug use and suicidal ideation. CONCLUSION Limitations of the study include the measure for BPD symptom severity was only collected pretreatment and the results are likely limited to the effects of cannabis use on suicidal ideation. Clinicians may need to consider the prolonged effects of drug use on suicidal ideation when conducting chain analyses on suicidal behaviors.
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Affiliation(s)
- Matison W. McCool
- The Center on Alcohol, Substance Use, And Addictions, The University of New Mexico
| | | | - John E. Lothes
- University of North Carolina Wilmington
- Delta Behavioral Health
| | - Eric Guendner
- University of North Carolina Wilmington
- Delta Behavioral Health
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11
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Morawetz C, Berboth S, Chirokoff V, Chanraud S, Misdrahi D, Serre F, Auriacombe M, Fatseas M, Swendsen J. Mood Variability, Craving, and Substance Use Disorders: From Intrinsic Brain Network Connectivity to Daily Life Experience. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:940-955. [PMID: 36775712 DOI: 10.1016/j.bpsc.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 10/13/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are major contributors to morbidity and mortality rates worldwide, and this global burden is attributable in large part to the chronic nature of these conditions. Increased mood variability might represent a form of emotional dysregulation that may have particular significance for the risk of relapse in SUD, independent of mood severity or diagnostic status. However, the neural biomarkers that underlie mood variability remain poorly understood. METHODS Ecological momentary assessment was used to assess mood variability, craving, and substance use in real time in 54 patients treated for addiction to alcohol, cannabis, or nicotine and 30 healthy control subjects. Such data were jointly examined relative to spectral dynamic causal modeling of effective brain connectivity within 4 networks involved in emotion generation and regulation. RESULTS Differences in effective connectivity were related to daily life variability of emotional states experienced by persons with SUD, and mood variability was associated with craving intensity. Relative to the control participants, effective connectivity was decreased for patients in the prefrontal control networks and increased in the emotion generation networks. Findings revealed that effective connectivity within the patient group was modulated by mood variability. CONCLUSIONS The intrinsic causal dynamics in large-scale neural networks underlying emotion regulation play a predictive role in a patient's susceptibility to experiencing mood variability (and, subsequently, craving) in daily life. The findings represent an important step toward informing interventional research through biomarkers of factors that increase the risk of relapse in persons with SUD.
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Affiliation(s)
- Carmen Morawetz
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
| | - Stella Berboth
- Institute of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Valentine Chirokoff
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
| | - Sandra Chanraud
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
| | - David Misdrahi
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Fuschia Serre
- Centre National de la Recherche Scientifique UMR 6033 - Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
| | - Marc Auriacombe
- Centre National de la Recherche Scientifique UMR 6033 - Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France; Centre Hospitalier Charles Perrens, Bordeaux, France; Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Melina Fatseas
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; Centre Hospitalier Universitaire Bordeaux, Bordeaux, France
| | - Joel Swendsen
- National Centre for Scientific Research UMR 5287 - Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, University of Bordeaux, Bordeaux, France; École pratique des hautes études, Paris Sciences et Lettres Research University, Paris, France
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12
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Ruyak SL, Roberts MH, Chambers S, Ma X, DiDomenico J, De La Garza R, Bakhireva LN. Impulsivity and Alcohol Use during Pregnancy and Postpartum: Insights from Novel Methodological Approaches within the Context of the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:600. [PMID: 37504047 PMCID: PMC10376597 DOI: 10.3390/bs13070600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Impaired emotion regulation and impulsivity have been linked to substance use. This study evaluated the association between emotion regulation difficulties-specifically impulsivity-and substance use within the context of the COVID-19 pandemic among pregnant (n = 49) and postpartum (n = 20) women. Participants from a prospective cohort ENRICH-2 completed a baseline phone survey of COVID-19-related experiences and impulsivity followed by a 14-day (3x/day) mobile ecological momentary assessment (mEMA) of impulsivity and substance use. Between-subject (BS) and within-subject (WS) associations for baseline impulsivity and momentary impulsivity with respect to substance use were examined using mixed effects models. At the BS level, momentary impulsivity scores that were higher than the overall group average were positively associated with subsequent momentary reports of marijuana use (β = 1.25; p = 0.04) when controlling for pregnancy status and COVID-19-related stress. At the WS level, momentary impulsivity scores that were higher than an individual's average score were positively associated with subsequent reports of momentary alcohol use (β = 0.08; p = 0.04). This research supports the idea that impulsivity varies based on individual situations, such as stress associated with the COVID-19 pandemic, and may be an important correlate of substance use in pregnant and postpartum women. Future research might consider investigation of additional factors, which may serve to moderate or mediate the relationship between impulsivity and substance use.
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Affiliation(s)
- Sharon L Ruyak
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Stephanie Chambers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Xingya Ma
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Richard De La Garza
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
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13
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Castellini G, Merola GP, Baccaredda Boy O, Pecoraro V, Bozza B, Cassioli E, Rossi E, Bessi V, Sorbi S, Nacmias B, Ricca V. Emotional dysregulation, alexithymia and neuroticism: a systematic review on the genetic basis of a subset of psychological traits. Psychiatr Genet 2023; 33:79-101. [PMID: 36729042 PMCID: PMC10158611 DOI: 10.1097/ypg.0000000000000335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/24/2022] [Indexed: 02/03/2023]
Abstract
Neuroticism, alexithymia and emotion dysregulation are key traits and known risk factors for several psychiatric conditions. In this systematic review, the aim is to evaluate the genetic contribution to these psychological phenotypes. A systematic review of articles found in PubMed was conducted. Search terms included 'genetic', 'GWAS', 'neuroticism', 'alexithymia' and 'emotion dysregulation'. Risk of bias was assessed utilizing the STREGA checklist. Two hundred two papers were selected from existing literature based on the inclusion and exclusion criteria. Among these, 27 were genome-wide studies and 175 were genetic association studies. Single gene association studies focused on selected groups of genes, mostly involved in neurotransmission, with conflicting results. GWAS studies on neuroticism, on the other hand, found several relevant and replicated intergenic and intronic loci affecting the expression and regulation of crucial and well-known genes (such as DRD2 and CRHR1). Mutations in genes coding for trascriptional factors were also found to be associated with neuroticism (DCC, XKR6, TCF4, RBFOX1), as well as a noncoding regulatory RNA (LINC00461). On the other hand, little GWAS data are available on alexythima and emotional dysregulation.
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Affiliation(s)
| | | | | | | | | | | | | | - Valentina Bessi
- Neurology Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Sandro Sorbi
- Neurology Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Benedetta Nacmias
- Neurology Unit, Department of Health Sciences, University of Florence, Florence, Italy
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14
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Amini M, Abdolahpur MA, Bach B, Darharaj M, Hamraz I, Javaheri A, Lotfi M. The Relationship between Traumatic Life Events and Polysubstance Use: Examining the Mediating Role of DSM-5 Level of Personality Functioning and Maladaptive Personality Traits. THE JOURNAL OF PSYCHOLOGY 2023; 157:227-241. [PMID: 36919464 DOI: 10.1080/00223980.2023.2182265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The experience of traumatic events in childhood is an important risk factor for the initiation and continuation of polysubstance use. This study aimed to examine the mediating role of DSM-5 level of personality functioning and maladaptive personality traits in the relationship between traumatic life events and polysubstance use. We used a mixed sample (N = 290; Mage = 40; SDage = 12.26; 75.2% males) of patients with substance use disorder (SUD; including 90 mono-drug users and 113 polysubstance users) and non-users (including 87 university students) recruited using convenience sampling method from harm reduction-oriented drug treatment centers and universities respectively in Tehran, Iran. Participants completed the Level of Personality Functioning Scale-Brief Form, the Personality Inventory for DSM 5-Brief Form, and the Life Events Checklist-Revised. The results of structural equation modeling showed that DSM-5 level of personality functioning and maladaptive personality traits partially mediated the relationship between traumatic life events and polysubstance use. Experiencing traumatic events may contribute to the risk of polysubstance use through the effect of global personality dysfunction and specific personality traits. This proposed mediational model must be replicated using a longitudinal design across different populations.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit
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15
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Mavragani A, Lecomte T, Potvin S, Riopel G, Vézina C, Villeneuve M, Abdel-Baki A, Khazaal Y. A Mobile Health App (ChillTime) Promoting Emotion Regulation in Dual Disorders: Acceptability and Feasibility Pilot Study. JMIR Form Res 2023; 7:e37293. [PMID: 36705963 PMCID: PMC9919461 DOI: 10.2196/37293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND A growing number of studies highlight the importance of emotion regulation in the treatment and recovery of individuals with psychosis and concomitant disorders such as substance use disorder (SUD), for whom access to integrated dual-disorder treatments is particularly difficult. In this context, dedicated smartphone apps may be useful tools to provide immediate support to individuals in need. However, few studies to date have focused on the development and assessment of apps aimed at promoting emotional regulation for people with psychosis. OBJECTIVE The aim of this study was to evaluate the feasibility, acceptability, and potential clinical impact of a dedicated app (ChillTime) for individuals with psychotic disorders and concurrent SUD. The app design process followed recommendations for reducing cognitive effort on a mobile app. A total of 20 coping strategies regrouped in four categories (behavioral, emotional, cognitive, spiritual) were included in the app. METHODS This open pilot study followed a pre-post design. After the initial assessment, researchers asked participants to use the app as part of their treatment over a 30-day period. Feasibility was determined by the frequency of use of the app and measured using the number of completed strategies. Acceptability was determined by measuring ease of use, ease of learning, satisfaction, and perceived utility at the end of the 30-day study period based on responses to satisfaction questionnaires. Clinical scales measuring emotion regulation, substance use (ie, type of substance, amount taken, and frequency of use), and various psychiatric symptoms were administered at the beginning and end of the 30-day period. RESULTS A total of 13 participants were recruited from two first-episode psychosis clinics in Montreal, Quebec, Canada. All participants were symptomatically stable, were between 18 and 35 years of age (mostly men; 70% of the sample), and had a schizophrenia spectrum disorder with a comorbid substance use diagnosis. A total of 11 participants completed the study (attrition<20%). Approximately half of the participants used the tool at least 33% of the days (11-21 days). Cognitive and emotion-focused techniques were rated the highest in terms of usefulness and were the most frequently used. The majority of participants gave positive answers about the ease of use and the ease of learning the tool. A nonsignificant association of ChillTime use with negative symptoms and drug use was observed. No other statistically significant changes were observed. CONCLUSIONS The ChillTime app showed good feasibility (approximately half of the participants used the tool at least 33% of the days) and acceptability among people with schizophrenia spectrum disorder and SUD. Trends suggesting a potential impact on certain clinical outcomes will need to be replicated in larger-sample studies before any conclusion can be drawn.
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Affiliation(s)
| | - Tania Lecomte
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Gabrielle Riopel
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Camille Vézina
- Département de Psychologie, Université de Montréal, Montreal, QC, Canada
| | - Marie Villeneuve
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Amal Abdel-Baki
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.,Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
| | - Yasser Khazaal
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Département de Psychiatrie, Université de Montréal, Montreal, QC, Canada
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16
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Fortier A, Dumais A, Athanassiou M, Tikàsz A, Potvin S. Dysconnectivity between the anterior insula and the dorsal anterior cingulate cortex during an emotion go/nogo paradigm is associated with aggressive behaviors in male schizophrenia patients. Psychiatry Res Neuroimaging 2023; 328:111579. [PMID: 36469978 DOI: 10.1016/j.pscychresns.2022.111579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/12/2022] [Accepted: 11/22/2022] [Indexed: 12/02/2022]
Abstract
This study aimed to investigate the association between past-reported violent/aggressive behaviors and brain functional connectivity in male patients suffering from schizophrenia using a task modeling the interaction between negative emotion processing and response inhibition. Forty-four male patients with schizophrenia and twenty-two healthy male controls performed an emotional go/no-go task using angry and neutral faces during a functional magnetic resonance imaging session. Generalized psycho-physiological interaction was conducted to explore task-based functional connectivity and a negative binomial regression was used to evaluate the relationship between neural alterations and violent/aggressive behaviors. Regions involved in response inhibition and emotion regulation, such as the anterior insula, dorsal anterior cingulate cortex (dACC) and dorsolateral prefrontal cortex (DLPFC), were used as seed regions. During emotion-related response inhibition, patients with schizophrenia displayed altered connectivity between the anterior insula and amygdala, the DLPFC and lateral orbitofrontal cortex (OFC), as well as the anterior insula and the dACC when compared to healthy individuals. The latter was negatively associated with aggressive behaviors in participants with schizophrenia (Wald χ2 = 9.51; p < 0.05, p-FDR corrected). Our results highlight alterations in functional connectivity in brain regions involved in cognitive control and emotion processing which are associated with aggressive behaviors in schizophrenia.
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Affiliation(s)
- Alexandra Fortier
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Alexandre Dumais
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada; Philippe-Pinel National Institute of Legal Psychiatry, Montreal, Canada
| | - Maria Athanassiou
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Andràs Tikàsz
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Stéphane Potvin
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada; Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.
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17
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Taubin D, Berger A, Greenwald D, Greenwald H, Burke C, Gongora DS, Wilens T. A systematic review of virtual reality therapies for substance use disorders: Impact on secondary treatment outcomes. Am J Addict 2023; 32:13-23. [PMID: 36128667 PMCID: PMC10557052 DOI: 10.1111/ajad.13342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 08/02/2022] [Accepted: 08/30/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Virtual reality (VR) therapy may be an effective tool in treating urges and cravings in substance use disorder (SUD). Given the high co-occurrence of difficulties with mood, anxiety, and emotional dysregulation with SUD, this review sought to examine the extant literature on the efficacy of VR for SUD in improving these secondary treatment outcomes. METHODS A systematic literature review was conducted following PRISMA guidelines in PubMed, PsychInfo, and Embase. Studies were included if they utilized immersive VR, were conducted with individuals with substance use disorder/dependence/misuse, and included measures of mood, anxiety, depression, emotional dysregulation, or retention in treatment. RESULTS Seven articles met our inclusion criteria. Five studies were conducted on patients using nicotine and utilized a cue-exposure intervention. VR was effective at reducing substance use and cravings in the majority of studies. Results on the efficacy of VR for improving mood, anxiety, and emotional regulation were mixed. Work examining retention in treatment was limited. DISCUSSION AND CONCLUSIONS VR for SUD has the potential to improve mood and anxiety symptoms as well as retention in treatment for patients with SUD, particularly if the therapy targets these psychological symptoms. Future studies examining components of VR for SUD in individuals with drug use disorders, as well as examinations of targeted interventions for associated mood, emotional dysregulation, and retention in treatment, are necessary. SCIENTIFIC SIGNIFICANCE This is the first systematic review of the impact of VR on mood, anxiety, and emotional dysregulation for individuals with substance use.
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Affiliation(s)
- Daria Taubin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Amy Berger
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | | | | | - Colin Burke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Dinah Sher Gongora
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Timothy Wilens
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
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18
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Stellern J, Xiao KB, Grennell E, Sanches M, Gowin JL, Sloan ME. Emotion regulation in substance use disorders: a systematic review and meta-analysis. Addiction 2023; 118:30-47. [PMID: 35851975 PMCID: PMC10087816 DOI: 10.1111/add.16001] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/19/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS The ability to regulate emotions effectively has been associated with resilience to psychopathology. Individuals with substance use disorders (SUDs) have been shown to have higher levels of negative emotionality, with some evidence suggesting impairment in emotion regulation compared with individuals without SUDs. However, no previous attempt has been made to systematically review the literature to assess the magnitude of this difference. We aimed to assess the association between SUD diagnosis and emotion regulation as measured by the Difficulties in Emotion Regulation Scale (DERS) and Emotion Regulation Questionnaire (ERQ) through a systematic review and meta-analysis of existing findings. METHODS The systematic review was conducted using PubMed, PsycINFO and Embase. We examined cross-sectional studies that compared a SUD group with a control group and measured emotion regulation using the DERS or the ERQ. The primary analysis focused on papers using the DERS, as this was the predominant instrument in the literature. RESULTS Twenty-two studies met our primary analysis criteria, representing 1936 individuals with a SUD and 1567 controls. Individuals with SUDs relative to controls had significantly greater DERS scores, with a mean difference of 21.44 [95% confidence interval (CI) = 16.49-26.40, P < 0.001] and Hedges' g = 1.05 (95% CI = 0.86-1.24, P < 0.001). The difference was robust, remaining significant after removing outliers and studies with high risk of bias. Individuals with SUDs demonstrated poorer emotion regulation on each subscale of the DERS, with the largest deficits in the Strategies and Impulse subscales. The ERQ analysis revealed greater use of expressive suppression in those with SUDs relative to controls (Hedges' g = 0.76, 95% CI = 0.25-1.28, P = 0.004). CONCLUSIONS People with substance use disorders appear to have greater difficulties in emotion regulation than people without substance use disorders.
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Affiliation(s)
- Jordan Stellern
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ke Bin Xiao
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Erin Grennell
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marcos Sanches
- Biostatistics Core, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Joshua L Gowin
- Department of Radiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Matthew E Sloan
- Addictions Division, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.,Division of Neurosciences and Clinical Translation, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
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19
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Patel H, Easterbrook B, D'Alessandro-Lowe AM, Andrews K, Ritchie K, Hosseiny F, Rodrigues S, Malain A, O'Connor C, Schielke H, McCabe RE, Nicholson AA, Lanius R, McKinnon MC. Associations between trauma and substance use among healthcare workers and public safety personnel during the SARS-CoV-2 (COVID-19) pandemic: the mediating roles of dissociation and emotion dysregulation. Eur J Psychotraumatol 2023; 14:2180706. [PMID: 36930578 PMCID: PMC10026820 DOI: 10.1080/20008066.2023.2180706] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Given the highly stressful environment surrounding the SARS-CoV-2 pandemic, healthcare workers (HCW) and public safety personnel (PSP) are at an elevated risk for adverse psychological outcomes, including posttraumatic stress disorder (PTSD) and alcohol/substance use problems. As such, the study aimed to identify associations between PTSD severity, related dissociation and emotion dysregulation symptoms, and alcohol/substance use problems among HCWs and PSP. METHODS A subset of data (N = 498; HCWs = 299; PSP = 199) was extracted from a larger study examining psychological variables among Canadian HCWs and PSP during the pandemic. Structural equation modelling assessed associations between PTSD symptoms and alcohol/substance use-related problems with dissociation and emotion dysregulation as mediators. RESULTS Among HCWs, dissociation fully mediated the relation between PTSD and alcohol-related problems (indirect effect β = .133, p = .03) and emotion dysregulation partially mediated the relation between PTSD and substance-related problems (indirect effect β = .151, p = .046). In PSP, emotion dysregulation fully mediated the relation between PTSD and alcohol-related problems (indirect effects β = .184, p = .005). For substance-related problems among PSP, neither emotion dysregulation nor dissociation (ps >.05) had any effects. CONCLUSION To our knowledge, this is the first study examining associations between PTSD severity and alcohol/substance use-related problems via mediating impacts of emotion dysregulation and dissociation among HCWs and PSP during the SARS-CoV-2 pandemic. These findings highlight dissociation and emotion dysregulation as important therapeutic targets for structured interventions aimed at reducing the burden of PTSD and/or SUD among Canadian HCWs or PSP suffering from the adverse mental health impacts of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Herry Patel
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Bethany Easterbrook
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
| | | | - Krysta Andrews
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Kimberly Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | | | - Sara Rodrigues
- The Atlas Institute for Veterans and Families, Ottawa, Canada
| | | | | | | | - Randi E McCabe
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Canada
- Mental Health and Addictions Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Andrew A Nicholson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, Canada
- Homewood Research Institute, Guelph, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
- Mental Health and Addictions Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
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20
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Florimbio AR, Coughlin LN, Bauermeister JA, Young SD, Zimmerman MA, Walton MA, Bonar EE. Risky Drinking in Adolescents and Emerging Adults: Differences between Individuals Using Alcohol Only versus Polysubstances. Subst Use Misuse 2022; 58:211-220. [PMID: 36537360 PMCID: PMC9877190 DOI: 10.1080/10826084.2022.2152192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Factors related to risky drinking (e.g., motives, protective behavioral strategies [PBS]) may vary between youth who engage in polysubstance use compared to those who consume alcohol only. We examined differences in factors among youth who consume alcohol only compared to alcohol with other substances (i.e., polysubstance use), and correlates associated with risky drinking between the groups. METHODS Participants (N = 955; ages 16-24; 54.5% female) who reported recent risky drinking completed measures of alcohol/substance use, alcohol-related consequences, drinking motives, alcohol PBS, mental health symptoms, and emotion dysregulation. Participants were in the polysubstance group if they reported using at least one other substance (e.g., cannabis, stimulants) in addition to alcohol in the past three months. Chi-square and t-tests examined differences between the two groups and multiple regression analyses examined correlates of risky drinking. RESULTS Most participants (70.4%, n = 672) reported polysubstance use; these individuals engaged in riskier patterns of drinking, experienced more alcohol-related consequences, used fewer PBS, had stronger drinking motives (enhancement, social, coping), endorsed more mental health symptoms, and reported more emotion dysregulation. Regression models showed that emotion dysregulation significantly associated with risky drinking in the alcohol-only group; conformity and coping motives, alcohol PBS, and anxiety symptoms significantly associated with risky drinking in the polysubstance group. CONCLUSIONS Among risky drinking youth, results indicated youth engaging in polysubstance use have greater comorbidities and individual-level factors associated with risky drinking than youth who consume alcohol only. These findings may inform the tailoring of interventions for individuals who engage in risky drinking and polysubstance use.
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Affiliation(s)
- Autumn Rae Florimbio
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
| | - Lara N. Coughlin
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - José A. Bauermeister
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Sean D. Young
- Department of Emergency Medicine, University of California, Irvine, Irvine, CA, USA
- Department of Informatics, University of California, Irvine, Irvine, CA, USA
| | - Marc A. Zimmerman
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Maureen A. Walton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
| | - Erin E. Bonar
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, University of Michigan, Ann Arbor, MI, USA
- Injury Prevention Center, University of Michigan, Ann Arbor, MI, USA
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21
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Jiang H, Ding X, Zhao S, Li Y, Bai H, Gao H, Gao W. Abnormal brain oscillations and activation of patients with heroin use disorder during emotion regulation: The role of delta- and theta-band power. J Affect Disord 2022; 315:121-129. [PMID: 35878830 DOI: 10.1016/j.jad.2022.07.018] [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: 10/16/2021] [Revised: 04/19/2022] [Accepted: 07/16/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND Emotion dysregulation is a crucial component of substance use disorders in predisposition, maintenance, and relapse. Emotional regulation strategies are an important factor in emotion dysregulation. However, studies on heroin use disorder (HUD) patients' ability to use emotion regulation strategies are scarce. METHODS Time-frequency-based analyses were used to compare the power of 33 patients with HUD and 28 healthy controls to elucidate whether patients with HUD have abnormal neural oscillations during passive viewing and emotion regulation strategies. Using the standardized low-resolution brain electromagnetic tomography algorithm (sLORETA), we estimated the possible sources of the anomalous band power. RESULTS Compared to patients with HUD, healthy controls showed a stronger decrease in the power of the delta/theta band across all task conditions. The effect peaked at approximately 1300-1900 ms after stimulus onset and varied by task condition. The estimation of sLORETA suggested the frontal, parietal, and limbic lobes as possible generators. LIMITATIONS We cannot exclude the potential influence of additional factors, such as sex, depression and anxiety levels, and polysubstance use, on the results. CONCLUSIONS Patients with HUD have blunted arousal and impaired ability to use emotion regulation strategies. The abnormal patterns described above may be the underlying neurophysiological basis for this dysfunction. Future studies could combine different approaches to improve emotion dysregulation in patients with HUD to promote treatment outcomes.
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Affiliation(s)
- Heng Jiang
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Xiaobin Ding
- School of Psychology, Northwest Normal University, Lanzhou, China.
| | - Shan Zhao
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Yiyao Li
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Haoyang Bai
- School of Psychology, Northwest Normal University, Lanzhou, China
| | - Hongxia Gao
- Lanzhou Drug Rehabilitation Hospital, Lanzhou, China
| | - Wenwen Gao
- Lanzhou Drug Rehabilitation Hospital, Lanzhou, China
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22
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Secades-Villa R, Aonso-Diego G, González-Roz A. A randomized controlled trial of contingency management for smoking cessation in substance use treatment patients. Int J Clin Health Psychol 2022; 22:100314. [PMID: 35662791 PMCID: PMC9157212 DOI: 10.1016/j.ijchp.2022.100314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/03/2022] [Indexed: 12/04/2022] Open
Abstract
Background/Objective Contingency management (CM) is one of the most effective interventions for smokers with substance use disorder (SUD), and no empirical assessment of its long-term efficacy has been conducted so far in a real-world context. The objectives were: (1) examine the additive effectiveness of CM on cognitive-behavioral treatment (CBT) for smoking cessation, and (2) examine the relationship between smoking cessation and substance use abstinence. Method A total of 80 participants (75.8% males; Mage = 45.31; SD = 9.64) were assigned to two smoking cessation treatments: CBT or CBT+CM. A set of generalized estimating equations were conducted to examine the effect of treatment condition on smoking outcomes, as well as the effect of smoking status on substance abstinence. Results Adding CM to CBT for smoking cessation improved tobacco abstinence rates at the end-of-treatment (p = .049). Tobacco abstinence rates declined over time (p = .012), but no significant effects of treatment condition were observed across follow-ups (p = .260). Smoking cessation was not significantly related to substance abstinence (p ≥ .488). Conclusions CM facilitates early abstinence in smokers with SUD, although effects subside after treatment termination. The lack of association between smoking abstinence and substance use suggests no jeopardizing effects as a result of quitting smoking.
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Affiliation(s)
- Roberto Secades-Villa
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
| | - Gema Aonso-Diego
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
- Corresponding author.
| | - Alba González-Roz
- Addictive Behaviors Research Group, Faculty of Psychology, University of Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
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23
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Hinckley JD, Danielson CK. Elucidating the Neurobiologic Etiology of Comorbid PTSD and Substance Use Disorders. Brain Sci 2022; 12:brainsci12091166. [PMID: 36138902 PMCID: PMC9496654 DOI: 10.3390/brainsci12091166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/26/2022] Open
Abstract
Early childhood maltreatment and other traumatic event experiences ("trauma") are common among youth, including those with substance use problems including substance use disorders (SUD). Particularly, interpersonal violence is associated with high rates of comorbidity between posttraumatic stress disorder (PTSD) and SUD, and these comorbid disorders exhibit high levels of overlapping symptomatology. Theoretical models proposed to explain the bidirectional relationship between PTSD and SUD include the self-medication hypothesis and susceptibility hypothesis. In this article, we explore neurobiologic changes associated with trauma, PTSD, and SUD that underly dysregulated stress response. Examining lessons learned from recent translational and clinical research, we propose that further elucidating the neurobiologic etiology of comorbid PTSD and SUD will require a collaborative, interdisciplinary approach, including the integration of preclinical and clinical studies, exploration of biologic markers in clinical studies, and accumulation of larger studies and longitudinal studies with the power to study PTSD and SUD. Such research can transform the field and ultimately reduce high rates and costly impairment of co-occurring PTSD and SUD across the lifespan.
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Affiliation(s)
- Jesse D. Hinckley
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Court, MS-F570, Aurora, CO 80045, USA
- Correspondence:
| | - Carla Kmett Danielson
- National Crime Victims Research & Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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24
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Predicting Relapse in Substance Use: Prospective Modeling Based on Intensive Longitudinal Data on Mental Health, Cognition, and Craving. Brain Sci 2022; 12:brainsci12070957. [PMID: 35884763 PMCID: PMC9319974 DOI: 10.3390/brainsci12070957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
Patients with severe substance use disorders are often characterized by neurocognitive impairments and elevated mental health symptom load, typically associated with craving intensity and substance use relapse. There is a need to improve the predictive capabilities of when relapse occurs in order to improve substance use treatment. The current paper contains data from 19 patients (seven females) in a long-term inpatient substance use treatment setting over the course of several weeks, with up to three weekly data collections. We collected data from 252 sessions, ranging from 1 to 24 sessions per subject. The subjects reported craving, self-control, and mental health on each occasion. Before starting the repeated data collection, a baseline neuropsychological screening was performed. In this repeated-measures prospective study, the mixed-effects models with time-lagged predictors support a model of substance use craving and relapse being predicted by the baseline reaction time as well as the temporal changes and variability in mental health symptom load, self-control, and craving intensity with moderate to high effect sizes. This knowledge may contribute to more personalized risk assessments and treatments for this group of patients.
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25
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El Archi S, Barrault S, Brunault P, Ribadier A, Varescon I. Co-occurrence of Adult ADHD Symptoms and Problematic Internet Use and Its Links With Impulsivity, Emotion Regulation, Anxiety, and Depression. Front Psychiatry 2022; 13:792206. [PMID: 35492700 PMCID: PMC9045584 DOI: 10.3389/fpsyt.2022.792206] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/28/2022] [Indexed: 12/24/2022] Open
Abstract
The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and problematic Internet use (PIU) is associated with increased severity of PIU and poorer treatment outcomes. The main objective of this study was to examine the association between PIU and adult ADHD symptoms and determine whether adult ADHD symptoms were a predictor of PIU in the general adult population. We also examined the potential mediating role of the dimensional psychopathological factors, including anxiety, depression, impulsivity, and emotion regulation, in this relationship. To achieve these aims, we recruited 532 regular Internet users online from the general adult population. The participants completed an online questionnaire assessing PIU (Internet Addiction Test), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), adult ADHD symptoms (Adult ADHD Self-Report Scale-V1.1), emotion regulation (Emotion Regulation Questionnaire), and impulsivity (UPPS-P Impulsive Behavior Scale). We conducted a multiple regression analysis to determine the predictors of PIU and mediation analyses to identify the psychopathological mediators of the association between adult ADHD symptoms and PIU. PIU was observed in 17.9% of our sample. A significantly higher proportion of respondents with PIU screened positive for adult ADHD symptoms compared to respondents without PIU (50.5 vs. 21.7%; p < 0.001). Individuals with PIU reported significantly higher scores than those without PIU for anxiety and depressive symptoms, impulsivity, and the emotion regulation strategy of expressive suppression. Additionally, they had significantly lower scores than those without PIU on cognitive reappraisal than non-problematic Internet users. In addition to adult ADHD symptoms, the multiple regression analysis revealed that PIU was also positively predicted by depressive symptoms, positive urgency, lack of perseverance, and expressive suppression, and is negatively predicted by cognitive reappraisal and negative urgency. The mediation analysis showed that lack of perseverance, positive urgency, and depressive and anxiety symptoms were partial mediators of the relationship between adult ADHD symptoms and PIU. Our results highlight the significant co-occurrence of PIU and adult ADHD symptoms. This study also provides support for a theoretical model in which impulsivity dimensions, emotion regulation strategies, as well as the tendency to anxiety and depressive symptoms, may play a mediating role in this co-occurrence. In summary, the findings emphasize the need to assess these psychological characteristics in problematic Internet users, as they can be a factor of clinical complexity, as well as the importance of targeting them as part of integrated interventions for both adult ADHD symptoms and PIU.
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Affiliation(s)
- Sarah El Archi
- University of Tours, Laboratory QualiPsy, EE1901, Tours, France
| | - Servane Barrault
- University of Tours, Laboratory QualiPsy, EE1901, Tours, France.,CHRU of Tours, Centre de Soins d'Accompagnement et de Prévention en Addictologie (CSAPA 37), Tours, France.,Université Paris Cité, Laboratory of Psychopathology and Health Processes, Boulogne-Billancourt, France
| | - Paul Brunault
- University of Tours, Laboratory QualiPsy, EE1901, Tours, France.,CHRU of Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France.,University of Tours, UMR 1253, iBrain, INSERM, Tours, France
| | - Aurélien Ribadier
- University of Tours, Laboratory QualiPsy, EE1901, Tours, France.,Université Paris Cité, Laboratory of Psychopathology and Health Processes, Boulogne-Billancourt, France
| | - Isabelle Varescon
- Université Paris Cité, Laboratory of Psychopathology and Health Processes, Boulogne-Billancourt, France
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26
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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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