Behavioral and emotional regulation and adolescent substance use problems: a test of moderation effects in a dual-process model

Non-suicidal self-injury and suicidal ideation among adolescents: the chain-mediating role of rumination and decentering

Objective

To explore the relationship between non-suicidal self-injury and suicidal ideation in adolescents and examine the roles of rumination and decentering in that relationship.

Method

By means of a questionnaire, 175 adolescent patients in a psychiatric hospital in Fujian Province were given the Functional Assessment of Self-Mutilation: Chinese Version, Positive and Negative Suicide Ideation, Ruminative Response Scale: Chinese Version, and Experiences Questionnaire: Decentering Scale.

Results

(1) Adolescent non-suicidal self-injury was significantly positively related to suicidal ideation and rumination and significantly negatively related to decentering. Suicidal ideation was significantly positively related to rumination and significantly negatively related to decentering. Rumination was significantly negatively related to decentering. (2) Rumination and decentering played a complete chain-mediating role between non-suicidal self-injury and suicidal ideation. Non-suicidal self-injury was found to indirectly affect suicidal ideation along three pathways: the independent mediating role of rumination (the mediating effect accounted for 40.166%), independent mediating role of decentering (the mediating effect accounted for 41.274%), and chain-mediating role of rumination and decentering (the mediating effect accounted for 14.958%).

Conclusion

Adolescent non-suicidal self-injury can indirectly affect suicidal ideation through rumination and decentering. In the future, mindfulness and other methods should be used to improve individuals' levels of decentering and cultivate emotional regulation abilities, so as to reduce the incidence of non-suicidal self-injury and suicide in adolescents.

Evaluation of depression, anxiety symptoms, emotion regulation difficulties, and self-esteem in children and adolescents with obesity

OBJECTIVE

Pediatric obesity negatively affects many areas of mental health, especially anxiety and depression. This study aimed to investigate the effects of obesity on anxiety, depression, self-esteem, and emotion regulation in children and adolescents.

METHODS

Our study included 50 children and adolescents aged 11-17 years with a diagnosis of obesity and 48 control participants. The Revised Child Anxiety and Depression Scale (RCADS), Rosenberg Self-Esteem Scale (RSE), Difficulties in Emotion Regulation Scale (DERS), and Piers-Harris Children's Self-Concept Scale 1 (PHCSCS) were administered to all participants.

RESULTS

A significant difference was found between the groups (p < 0.05) in the analysis of the PHCSCS and RCADS total score; the GAD, PD, SOC, and MDD subscale scores; the DERS total score; the Clarity, Impulse, Strategies, Goals subscale scores; and the RSE Self-Esteem subscale. A significant correlation was found between the PHCSCS, RCADS, DERS, and RSE total scores and some subscale scores (p < 0.05).

CONCLUSION

On the basis of the results, it was determined that children and adolescents with obesity had high levels of anxiety and depression symptoms, they had lower self-esteem, and had more difficulties in emotion regulation. Furthermore, those with anxiety and depression symptoms had lower self-esteem, and the children who had problems in emotion regulation also had lower self-esteem. Anxiety, depression, low self-esteem, and difficulties in emotion regulation can negatively affect obesity treatment. Therefore, screening and treatment of these conditions are of great importance.

The Effect of Future Time Perspective on Internet Dependence Among College Students in Pandemic Time: A Moderated Mediation Analysis

Purpose

Social isolation during the COVID-19 pandemic has greatly increased the probability of Internet dependence. This study sought to examine the relation between future time perspective and college students' Internet dependence, as well as the mediating role of boredom proneness and the moderating effect of self-control in the link between boredom proneness and Internet dependence.

Materials and Methods

A questionnaire survey was carried out among college students from two universities in China. A sample of 448 participants varying from freshmen to seniors completed questionnaires on future time perspective, Internet dependence, boredom proneness and self-control.

Results

Results indicated that college students with high future time perspective were less likely to fall into Internet dependence and boredom proneness mediated this relationship. The relation between boredom proneness and Internet dependence was moderated by self-control. Boredom proneness had a greater impact on Internet dependence for students with low self-control.

Conclusion

Future time perspective could influence Internet dependence through the mediating role of boredom proneness, which is moderated by self-control. The results advanced our understanding of how future time perspective affected college students' Internet dependence, revealing that intervention strategies which could improve students' self-control would be instrumental in reducing Internet dependence.

Does the Power of Social Example Fade? Nudge Effect of Social Information on Individual's Donation Behaviors During the COVID-19 Pandemic: A Moderated Mediation Model with Three-Wave Cross-Sectional Data

Purpose

This study assesses how various social information influence individuals' money donation behaviors towards charitable funds against the COVID-19 pandemic at different stages of the pandemic. It also explores the mediating role of social anxiety and the moderating role of self-control.

Materials and Methods

This three-wave study was conducted with online survey experiments using convenience sampling at the pandemic's outbreak stage (April-June 2020), trough stage (February-March 2021), and resurgence stage (May 2022) in China. The nudge power of social information was measured by whether participants changed their initial money donation decisions after informed positive or negative social information. Self-report scales were used to measure levels of social anxiety (Social Interaction Anxiety Scale) and self-control (Self-Control Scale). The final data set included 1371 participants from 26 provinces of mainland China. Stata medeff package and SPSS PROCESS were used to analyze the data.

Results

Individuals' initial donation behaviors did not fluctuate along with the pandemic status, but the nudge effect of social information did. From outbreak stage to trough stage, the nudge power of positive social information significantly declined, but did not significantly change again at the resurgence stage. By contrast, the nudge power of negative social information did not significantly differ between outbreak and trough stage but did significantly increase at the resurgence stage. Social anxiety played a significant mediating role in the relationship between COVID-19 status and power of social information. Moreover, self-control moderated the direct effect of COVID-19 status on power of social information and the indirect effect via social anxiety.

Conclusion

Our findings enrich research on the nudge power variation of social information on individuals' donation behaviors along with the pandemic status and its potential psychological influence factors. This study also helps guide organizations to better design and carry out social information nudge mechanism.

What Predicts Willingness to Experience Negative Consequences in College Student Drinkers?

OBJECTIVE

Research has shown that students who were more willing to experience consequences reported higher rates of alcohol consumption and negative consequences. The present study used a longitudinal design to examine intra- and interpersonal consequence-specific predictors of willingness to experience negative consequences.

METHOD

Students (N = 2,024) were assessed in the fall (Time [T] 1) and spring (T2) semesters of their first year in college. Intrapersonal constructs (i.e., expectancies, subjective evaluations, self-efficacy), interpersonal constructs (i.e., peer descriptive, injunctive norms), and personality constructs (i.e., self-regulation, impulsivity, sensation seeking) were assessed at T1 and willingness to experience negative alcohol-related consequences was assessed 6 months later. A structural path model examined the relationship between T1 predictors and T2 willingness. T1 drinking and sex were included as covariates.

RESULTS

These results demonstrated significant positive relationships between T1 participants' subjective evaluations of consequences, expectancies of experiencing consequences, and T2 willingness to experience negative consequences. Further, impulsivity, sensation seeking, and T1 drinking showed significant, positive associations with willingness, whereas higher self-regulation was significantly associated with lower willingness. Men were significantly more willing to experience negative consequences than women. No significant associations were observed between normative perceptions and willingness.

CONCLUSIONS

Intrapersonal and personality constructs, as well as previous drinking, were significantly associated with willingness to experience consequences whereas interpersonal constructs were not. Men were significantly more willing to experience negative consequences. College student interventions may benefit from focusing on significant constructs identified in the current study (e.g., enhancing self-regulation) and focusing on students with higher willingness to experience negative consequences.

Reward sensitivity and hazardous alcohol consumption in women: The parallel mediation effect of self-control and impulsivity traits

Introduction: Little research has been carried out on the associations between several individual factors and hazardous alcohol use in women. The aim of this study was first, to study the relationship between reward sensitivity (RS) and alcohol use in both women with and without hazardous drinking separately. Second, to explore the potential mediating roles of the impulsivity and self-control traits in this relationship. Method: The study was analytical and cross-sectional and included 645 female participants (mean age = 19.14; standard deviation (SD)=1.60). All women were divided into two groups (286, 44.3%, with hazardous drinking, HDW; and 359, 55.7%, with light drinking, LDW). Correlation analyses were carried out to explore the associations between the variables, and parallel mediation analyses were performed to investigate the potential mediating roles of impulsivity and self-control in the RS-alcohol use associations in each group separately. Results: A significant association was observed between RS and alcohol use in HDW, contrary to that observed in their counterparts. In addition, both higher impulsivity and less self-control mediated the association between RS and alcohol use only in HDW. Conclusions: Impulsivity and self-control differently affect alcohol use under the condition of high reward sensitivity, only in HDW, suggesting alterations of the dual top-down and bottom-up mechanisms and a possible imbalance between the competing reflexive and impulsive brain systems. More research is needed regarding the individual factors that affect women's drinking to develop sensitive measures for the assessment of alcohol use and more efficient interventions for women.

Acceptability of a Fentanyl Vaccine to Prevent Opioid Overdose and Need for Personalized Decision-Making

BACKGROUND

The opioid epidemic worsened during the coronavirus disease 2019 (COVID-19) pandemic. Synthetic opioids (primarily fentanyl) comprise the most common drugs involved in overdose (OD) death. A vaccine that blocks fentanyl from reaching the brain to prevent OD is under development, and insight is needed into its acceptability.

METHODS

Using a semi-structured interview guide, persons with opioid use disorder (OUD), family, professionals, and the public were interviewed about attitudes and concerns regarding a fentanyl vaccine. Reactions to fictional clinical vignettes of persons at risk of OUD because of pain and/or substance use histories were collected, analyzed, and quantified for favorability. Interviews were transcribed, coded, and analyzed thematically.

RESULTS

Among N = 64 participants, (70.3% female, average age 32.4 years), attitudes were favorable toward a fentanyl vaccine, with preference for lifelong durability (76% of n = 55 asked). Perceived benefits centered on the potential for a life-saving intervention, suffering averted, healthcare dollars saved, and the utility of a passive harm reduction strategy. Concerns centered on uncertainty regarding vaccine safety, questions about efficacy, worry about implications for future pain management, stigma, and need for supportive counseling and guidance to personalize decision making. Reactions to vignettes revealed complex attitudes toward fentanyl vaccination when considering recipient age, health history, and future risks for addiction and pain.

CONCLUSIONS

Positive responses to a fentanyl vaccine were found along with appreciation for the complexity of a vaccine strategy to prevent OD in the setting of pain and uncertain durability. Further research is needed to elucidate operational, ethical, and communications strategies to advance the model.

Cumulative Stressors and Adolescent Substance Use: A Review of 21st-Century Literature

The aim of this review is to assess empirical studies from the last 2 decades that have examined the association between cumulative stressors and adolescent substance use. Cumulative stressors were measured in these studies with adverse childhood experiences or adolescent stressful life events inventories. The 109 articles meeting the eligibility criteria that emerged from the review demonstrated a consistent, yet modest, association between cumulative stressors and adolescent substance use. Of note, several studies found that the associations were moderated or mediated by genetic factors related to cortisol regulation, intrapersonal factors such as low self-control, or interpersonal factors such as peer substance use. The review's findings thus suggest that efforts to reduce the effects of cumulative stressors on substance use could gainfully identify and target these risk moderators and mediators.

Self-Regulation Predicts Mental Health and Well-Being During the Covid-19 Pandemic: A Prospective Study

Introduction: As evidence of the psychological effects of the COVID-19 pandemic emerge, examining the role of self-regulation may yield key insights. This prospective study tested whether pre-pandemic self-regulation was associated with mental health, well-being, and substance use during the initial COVID-19 surge. Methods: Participants (N = 236; Mage = 30.3; 64% female) were assessed 1–3 years prior to the pandemic and again in April of 2020. Markers of self-regulation (vagal tone, attachment insecurity, stress-reactive rumination, and attentional control) were assessed at Time 1, as were depressive symptoms, sleep problems, relationship satisfaction, perceived stress, and substance use. These outcomes were assessed again during the pandemic, along with anxiety symptoms and peri-traumatic distress. Results: Poor pre-pandemic self-regulation was associated with higher peri-pandemic depressive and anxiety symptoms, peri-traumatic distress, and cannabis use. Self-regulation was not associated with sleep, relationship satisfaction, alcohol use, or drug use and did not moderate changes over time. Discussion: Prospective analyses indicated simultaneous, independent associations of cognitive and emotional self-regulation with mental health and well-being during the initial COVID-19 pandemic surge, yet pre-pandemic self-regulation did not account for trajectories of change over time. Findings emphasize the importance of prospective data for understanding biopsychosocial resilience during the pandemic and beyond.

Present hedonism and future time perspectives predicting hypersexuality and problematic pornography use

The Time Perspective (TP) theory (i.e., the psychological experience regarding time) was often examined in association with different addictive behaviors, and the different TPs (i.e., Past Positive, Past Negative, Present Hedonistic, Present Fatalistic, and Future TPs) demonstrated different relationship patterns with them. However, most studies were conducted in relation to substance use-related disorders, leaving crucial knowledge gaps concerning the associations between TPs and potential behavioral addictions. The aim of the present study was to examine the associations between the five TP dimensions, hypersexuality, and problematic pornography use (PPU), considering potential gender differences. Participants from two independent samples (N₁ = 554; N₂ = 453) completed a self-report survey on TPs and sexual behaviors. Structural equation modeling results indicated that the Present Hedonistic TP had a positive, moderate, and the Future TP had a negative, weak association with hypersexuality in both samples. Only the Present Hedonistic TP had a significant, positive, weak-to-moderate association with PPU across the samples. The explained variances of the models were higher in case of hypersexuality (28 and 27%, respectively), than in case of PPU (1 and 14%, respectively). No significant gender differences were observed. In line with previous findings concerning other predictors of hypersexuality and PPU, the results of the present study suggest that hypersexuality and PPU may differ from each other in terms of their TP background. Yet, present hedonism, which is related to impulsivity, may play an important role in both problematic sexual behaviors, suggesting that interventions focusing on this TP might be successful in reducing hypersexuality and PPU.

Binge Drinking, Tobacco, and Marijuana Use Among Young Adult Childhood Cancer Survivors: A Longitudinal Study

Objectives: Substance use among young adult childhood cancer survivors (YACCSs) has been found to increase during survivorship, resulting in increased risk of developing long-term negative health outcomes. This investigation sought to determine various risk and protective factors of tobacco, alcohol, or marijuana use over time among a sample of YACCSs. Methods: 127 YACCSs (57% Hispanic, 55% female, average age at diagnosis 12.4 years) who were diagnosed with any cancer type (except Hodgkin lymphoma) at two large pediatric medical centers in Los Angeles County between 2000 and 2007 responded to two surveys separated by ∼5 years. Bivariate logistic regression models were used to assess independent clinical and psychosocial Time 1 variables associated with each substance use outcome at Time 2. Time 1 variables significant at p < .10 were included in multivariable logistic regression models for each Time 2 substance use variable. Results: Rates of 30-day use increased over time for binge drinking alcohol (from 25.6% to 37.7%), marijuana (from 10.6% to 22.1%), and cigarette/tobacco (from 8.9% to 12.2%). Of the following Time 1 variables, marijuana use, cigarette use, and binge drinking were associated with Time 2 marijuana, cigarette, and binge drinking, respectively. Of the following clinical factors, receipt of more intensive cancer treatment was associated with decreased tobacco use. All other psychosocial and clinical factors analyzed were not associated with any increase or decrease in substance use. Conclusions: A greater emphasis on early health education efforts regarding the health risks of tobacco, alcohol, and marijuana use is needed in this at-risk population.

Women's Perceived Likelihood to Engage in Sexual Risk Taking: Posttraumatic Stress Symptoms and Poor Behavioral Regulation

Sexual abuse prior to age 18 may put some women at risk for engaging in sexual risk taking. This association could exist, in part, as a result of the impact of posttraumatic stress symptoms on behavioral regulation. The current study utilized a path analysis to investigate the association between severity of sexual abuse before age 18, posttraumatic stress symptoms, poor behavioral regulation, and expected engagement in sexual risk taking among college women. The sample consisted of 88 college women with experiences of sexual abuse prior to the age of 18. Severity of sexual abuse predicted posttraumatic stress symptoms. In addition, posttraumatic stress symptoms predicted poor behavioral regulation, which in turn predicted expected engagement in sexual risk taking. These findings indicate functional mechanisms involved in sexual decision making of women who have had past sexual abuse and experience posttraumatic stress symptoms.

Understanding the effects of personal factors and situational factors for adolescent cyberbullying perpetration: The roles of internal states and parental mediation

INTRODUCTION

The risk and protective factors of cyberbullying perpetration have been widely investigated. Less attention is paid to explore the effects of personal and situational factors, internal states, and external states in an integrated framework. This study aims to fill this void by developing an integrated framework to investigate the effects of power imbalance, the online disinhibition effect, internal states, and parental mediation on cyberbullying among Chinese adolescents.

METHODS

Multistage cluster random sampling was employed with 1103 adolescents (M_age = 15.3, 52.5% girls) who responded to the questionnaire. Structural equation modeling (SEM) was conducted.

RESULTS

Proficiency in technology use was directly related to cyberbullying. Social status among peers was found to be not only directly related to cyberbullying but also to operate through low self-control to predict cyberbullying. The online disinhibition effect did not directly correlate to cyberbullying but operated through moral disengagement and low self-control to predict cyberbullying. Notably, the results showed that physical power was neither directly correlated to cyberbullying nor aligned with moral disengagement or low self-control to predict cyberbullying. The multiple-group comparison analysis revealed that parental mediation moderated the effects of the online disinhibition effect on cyberbullying. However, this study found that parental mediation had no buffering effects when examining the relationships between physical power, social status, technology use, and cyberbullying.

CONCLUSIONS

Findings suggest that cyberbullying prevention should consider the effects of both internal states and external factors. The study has provided theoretical and practical implications for understanding and tackling the widespread problem of cyberbullying among adolescents.

Gender and racial/ethnic differences in adolescent intentions and willingness to smoke cigarettes: Evaluation of a structural equation model

Dual-process theories may be effective at predicting adolescent smoking; however, little is known about the effectiveness of these models across race/ethnicity and gender. Adolescents (N = 4035) completed biopsychosocial and tobacco-related perception measures in Grade 7 and reported on smoking initiation in Grade 10. Using structural equation modeling and comparing models by gender and race/ethnicity showed differences, where both intentions and willingness predicted smoking initiation for only Black and male adolescents, compared to their Latino and White and female counterparts. Intentions and willingness appear to play a role in whether an adolescent will initiate smoking in the future, but this does not apply universally across gender and race/ethnicity.

Validation of the Bar-On EQ-i: YV (S) Inventory in Its Spanish Version: Gender-Based Invariance Analysis

The purpose of this work is to verify the factorial structure and analyze the reliability of the Emotional Quotient Inventory (EQ-i): Youth Version (YV) (S) by evaluating emotional intelligence in a more extensive sample of Spanish adolescents than has been used to date, since this inventory has been employed in various studies but with a very limited number of participants. For this study, 5292 adolescents from all over Spain participated—male (51.2%) and female (48.8%) secondary education students between 11 and 19 years old, with an average age of 14.33. Data analysis included a Confirmatory Factor Analysis (CFA), reliability analysis, and model invariance as a function of gender. The CFA confirms that the data empirically support the theoretical model and that the goodness-of-fit indexes are adequate. The reliability analysis of the inventory presents a Cronbach’s alpha coefficient for the total scale of 0.76, and reliability indexes for each of the factors range between 0.63 and 0.80. The findings show that the model indicates invariance related to gender.

Emotional Eating in Adolescence: Effects of Emotion Regulation, Weight Status and Negative Body Image

Emotional eating is associated with an increased risk of binge eating, eating in the absence of hunger and obesity risk. While previous studies with children and adolescents suggest that emotion regulation may be a key predictor of this dysregulated eating behavior, little is known about what other factors may be influencing the link between emotional regulation and emotional eating in adolescence. This multi-method longitudinal study (n = 138) utilized linear regression models to examine associations between childhood emotion regulation, adolescent weight status and negative body image, and emotional eating at age 17. Emotion regulation predicted adolescent emotional eating and this link was moderated by weight status (β = 1.19, p < 0.01) and negative body image (β = -0.34, p < 0.01). Higher engagement in emotional eating was predicted by lower emotional regulation scores among normal-weight teens (β = -0.46, p < 0.001) but not among overweight/obese teens (β = 0.32, p > 0.10). Higher scores on emotion regulation were significantly associated with lower emotional eating at high (β = -1.59, p < 0.001) and low (β = -1.00, p < 0.01) levels of negative body image. Engagement in emotional eating was predicted by higher negative body image among overweight/obese teens only (β = 0.70, p < 0.001). Our findings show that while better childhood emotion regulation skills are associated with lower emotional eating, weight status and negative body image influence this link and should be considered as important foci in future interventions that aim to reduce emotional eating in adolescence.

Psychometric Properties and Measurement Invariance Across Sex of the Wong and Law Emotional Intelligence Scale in Chinese adolescents

The aim of this study was to validate the Wong and Law Emotional Intelligence Scale (WLEIS) in Chinese adolescents by examining factor structure, sex-related measurement invariance and latent mean differences, reliability, and criterion-related validity.A total of 1674 Chinese adolescents aged 12-17 years old (M_age = 15.26, SD = .58) were recruited. Results of confirmatory factor analysis (CFA) supported the four-factor model of the WLEIS as the best fit to the data. Multi-group CFA suggested that the measurement structure of the WLEIS was invariant across sex. Testing for the latent mean differences showed that male adolescents scored lower on the Other-Emotional Appraisal subscale, but scored higher on the Regulation of Emotion subscale than female adolescents. Furthermore, all the subscales of male and female adolescents had satisfactory composite reliability. Finally, the WLEIS had favorable criterion-related validity with self-esteem, life satisfaction, positive affect, negative affect and perceived stress. These findings suggested that the WLEIS is a reliable and valid instrument for assessing trait emotional intelligence of adolescents and can be generalized across sex.

Emotional Dysregulation in Adolescents: Implications for the Development of Severe Psychiatric Disorders, Substance Abuse, and Suicidal Ideation and Behaviors

Well-tuned emotional regulation is fundamental for human life and psychological well-being. Negative physiological emotions are counterbalanced by positive ones, and this equilibrium is the mainstay of human physiological affective states. However, this mechanism may sometimes become dysfunctional when negative emotions are not correctly counterbalanced, causing maladaptive behaviors, especially during adolescence. A very interesting review by Young et al. was recently published (Brain Sci.2019, 9(4), 76) and stimulated us to reflect on this topic. The screening for emotional disturbances and dysregulation in adolescents must be included in all the preventive and interventional programs aimed to achieve both physical and psychological well-being of the population and early intervention should be provided in order to avoid progression toward clinically relevant psychiatric disorders in late adolescence and adulthood.

Exposure to Family Violence of Israeli Inmates: Does Sex Make a Difference?

The purpose of the current study was to examine differences by sex (a) in history of child abuse and neglect (CAN) and exposure to parental partner violence (PPV); and (b) in the association of CAN and PPV with violent offenses, substance use, suicidal behavior, and psychiatric problems. This cross-sectional study investigated sex differences in CAN and exposure to PPV in a sample of 290 Israeli inmates (65 women and 225 men). Participants completed a self-report measures of the Childhood Trauma Questionnaire, and the revised Conflict Tactics Scale to measure PPV. The findings indicated that the female inmates had experienced significantly more sexual abuse (p < .001), and more exposure to PPV (p = .030), compared with male inmates. Female inmates who had experienced CAN were at higher risk of committing violent offenses than male inmates and female inmates were also more likely than male inmates to have been engaged in suicidal behaviors (39.3% and 18.5%, respectively), and to have had psychiatric problems (40% and 14.2%, respectively). The findings also revealed that psychiatric problems and suicidal behavior can be predicted by CAN and family substance use. The findings highlight the effects of the adverse childhood experience of exposure to CAN and PPV on behavioral problems. Appropriate treatment requires simultaneous intervention that targets all three issues of childhood trauma, substance use disorders, and psychiatric problems for both sexes.

Do Adolescents Use Substances to Relieve Uncomfortable Sensations? A Preliminary Examination of Negative Reinforcement among Adolescent Cannabis and Alcohol Users

Alcohol and cannabis use are highly prevalent among adolescents and associated with negative consequences. Understanding motivations behind substance use in youth is important for informing prevention and intervention efforts. The present study aims to examine negative reinforcement principles of substance use among adolescent cannabis and alcohol users by pairing a cue reactivity paradigm with an aversive interoceptive stimulus. Adolescents (ages 15–17), classified as controls (CTL; n = 18), cannabis and/or alcohol experimenters (CAN+ALC-EXP; n = 16), or individuals meeting clinical criteria for cannabis and/or alcohol use disorder (CAN+ALC-SUD; n = 13) underwent functional magnetic resonance imaging during which they experienced an aversive interoceptive probe delivered via breathing load while simultaneously performing a cue reactivity paradigm. Participants also provided self-report ratings of how their substance use is positively or negatively reinforced. While experiencing the breathing load, CAN+ALC-SUD exhibited greater (p < 0.05) deactivation in the right amygdala, the left inferior frontal gyrus, and the left parahippocampal gyrus than CAN+ALC-EXP and CTL, who did not differ. Across all substance users, activation during the breathing load within the left parahippocampal gyrus negatively correlated with cannabis and alcohol lifetime use episodes and the left inferior frontal gyrus activity negatively correlated with lifetime alcohol use episodes. CAN+ALC-SUD reported experiencing more positive and negative reinforcement of using their substance of choice than CAN+ALC-EXP; both user groups reported higher levels of positive than negative reinforcement. Adolescents with a cannabis/alcohol use disorder demonstrate an altered response to interoceptive perturbations. However, adolescent cannabis/alcohol use does not appear to be driven by negative reinforcement, as viewing substance images did not dampen this response. Based on self-report data, the experience of positive reinforcement may be stronger for adolescents. Future studies should examine whether positive reinforcement contributes to adolescent substance use.

The Mediating Role of Visual Stimuli From Media Use at Bedtime on Psychological Distress and Fatigue in College Students: Cross-Sectional Study

BACKGROUND

Empirical research has linked psychological distress with fatigue. However, few studies have analyzed the factors (eg, stimuli from bedtime media use) that affect the relationship between psychological distress and fatigue.

OBJECTIVE

The aim of this study was to examine whether visual stimuli from bedtime media use mediate the relationship between psychological distress and fatigue among college students.

METHODS

The sample included 394 participants (92 males, 302 females) with a mean age of 19.98 years (SD 1.43 years), all of whom were Chinese college students at an occupational university in Sichuan Province, China. Data were collected using a paper-based questionnaire that addressed psychological distress, stimuli from bedtime media use, and fatigue. Mediation analysis was conducted using the PROCESS macro version 2.16.2 for SPSS 22, which provided the 95% CIs.

RESULTS

Both psychological distress (r=.43, P<.001) and visual stimuli from bedtime media use (r=.16, P<.001) were positively related to fatigue. The association between auditory stimuli from bedtime media use and fatigue was not significant (r=.09, P=.08). The relationship between psychological distress and fatigue was partially mediated by visual stimuli from bedtime media use (beta=.01, SE 0.01, 95% CI 0.0023-0.0253).

CONCLUSIONS

The findings imply that psychological distress has an indirect effect on fatigue via visual stimuli from bedtime media use. In contrast, auditory stimuli from bedtime media use did not have the same effect. We suggest that college students should reduce bedtime media use, and this could be achieved as part of an overall strategy to improve health. Mobile health apps could be an option to improving young students' health in daily life.

Attachment Patterns in Subjects Diagnosed With a Substance Use Disorder: A Comparison of Patients in Outpatient Treatment and Patients in Therapeutic Communities

The purpose of the present study is to analyze the quality of attachment in substance abuse patients in outpatient treatment vs. patients in therapeutic communities in order to identify the role of attachment insecurity in choosing a care system. The sample consisted of 127 subjects (107 males and 20 females); 97 were outpatients (83 males) and 30 therapeutic community patients (24 males). Attachment with respect to current, significant relationships was assessed using the Relationship Questionnaire. In the outpatient subgroup, the prevailing attachment style was preoccupied; for the therapeutic community patients, the prevailing attachment style was dismissive. The dimensions of care (how the caregiver is perceived as loving and caring) and overprotection (how the caregiver is perceived as intrusive and interfering)-evaluated by means of the Parent Bonding Instrument-were higher in the outpatient subgroup. Scores were higher with respect to maternal subscales regardless of treatment modality. No differences emerged with respect to self-perceived symptoms (SCL-90-R) between the subgroups; however, fearful-avoidant and dismissive-avoidant individuals reported higher self-perceived symptom regardless of treatment modality. Understanding the distribution of different attachment patterns with respect to the treatment modality may improve efficacious interventions, attuning them to the individual and his or her developmental environment.

Students Choosing Courses: Real-Life Academic Decision Making

We examined how high school and college students make an important real-life decision: choosing the courses they will take in the upcoming academic year. Current high school and college students completed an online survey. Participants listed their course choices and the criteria they used to make their decisions (e.g., time a course meets, subject matter of a course) and also responded to a modified version of the Reactions to Decision instrument (Galotti, Tandler, & Weiner, 2014), which measured their affective reactions to the decision-making process. College students tended to list more options and criteria when describing their decisions than did high school students. High school students rated the future importance of their decisions higher and their independence in the decision-making process lower than did college students. College students reported using information specific to courses, such as instructor, time a class is scheduled, and the requirements a course met, as criteria when using courses more than did high school students. High school and college students who listed more criteria tended to be less certain and comfortable with the decision-making process than their peers. We discuss the context of this decision for each group of students.

Impulsive and Self-Regulatory Processes in Risky Driving Among Young People: A Dual Process Model

The present study empirically examined a novel dual process model of self-reported aberrant driving behavior in young and novice drivers that incorporates both impulsive and self-regulatory processes. Four hundred and nine participants aged 18-25 years (M age = 21.18 years, SD = 2.12; 65.5% females) completed online questionnaires on impulsivity, normlessness, sensation seeking, emotion and self-regulation, and attitudes toward driving safety. Path analysis showed that motor impulsivity was associated with self-reported driving violations, errors, and lapses, whereas sensation seeking was uniquely directly associated with self-reported errors. Non-planning impulsivity, normlessness and sensation seeking had significant indirect effects on self-reported errors, via self-regulation. Finally, motor impulsivity and normlessness had a significant indirect effect on self-reported violations, errors and lapses, via attitudes to driving safety. Based on our findings we suggest that a dual-process approach is relevant to the study of aberrant driving behavior in young and novice drivers, and the results of the present study have important implications for initiatives to promote driving safety in this population.

Religiosity and Effortful Control as Predictors of Indonesian Adolescents' Tobacco and Alcohol Use: Moderation and Mediation

Moderation and mediation models of religiosity and effortful control as predictors of tobacco and alcohol use were tested in this 2-year longitudinal study of 563 16-year-old Muslim Indonesian adolescents. Adolescents reported their effortful control, religiosity, and tobacco and alcohol use and peers provided reports of adolescents' effortful control. Although both moderation and mediation effects emerged when predicting Year 2 substance use, predictions of change from Year 1 to Year 2 substance use yielded effects of moderation for peer- but not self-reported effortful control for boys; no mediation effects emerged. These findings provide evidence of interconnections between effortful control and religiosity as predictors of substance use and suggest the need for further longitudinal studies that compare moderation and mediation models.

Childhood maltreatment and alcohol use in young adulthood: the role of self-regulation processes

INTRODUCTION

Childhood maltreatment has been linked to later alcohol use and disorders. Few studies have examined the pathways linking child maltreatment to alcohol use during the transition to adulthood. Currently, minimal understanding of such developmental pathways limits the success of alcohol prevention and intervention efforts for this highly vulnerable population. The present study examined if individual differences in self-regulation processes are critical factors that mediate the association between childhood maltreatment and risk for alcohol use.

METHOD

Young adults (N = 335; mean age = 21.7), who were recruited from the community, completed self-report measures of childhood maltreatment, different facets of self-regulation processes, and alcohol use. Multiple structural equation modeling (SEM) analyses were performed to specify the roles of two related, but different, self-regulation processes (i.e., behavioral self-control and behavioral dysregulation) in linking child maltreatment to four different patterns of drinking behaviors, including drinking frequency, binge drinking, alcohol-related problems, and alcohol dependence. Common risk factors for alcohol use, such as psychological symptoms and peer alcohol use, were also entered into the models.

RESULTS

We found that behavioral dysregulation particularly plays a mediating role in the associations between childhood emotional abuse and problematic alcohol use during young adulthood.

CONCLUSION

The results of this research suggest that self-control processes would be potentially useful targets to prevent problematic alcohol use among young people who have had exposure to childhood maltreatment.

Willingness as a mediator of the effects of personality on alcohol-related consequences between the first and second years of college: A longitudinal prospective study

The present study used a prospective longitudinal design to examine whether willingness to experience negative alcohol-related consequences mediated the effects of personality on consequences (e.g., blacking out, getting into a fight, and regretted sex). Students (N = 2024) were assessed at three time points: fall semester of the students' first year in college (baseline), 6-months post-baseline, and one-year post-baseline. Personality constructs were assessed at baseline (i.e., impulsivity, sensation seeking, self-regulation), willingness to experience negative alcohol-related consequences was assessed at baseline and 6-months, and negative alcohol-related consequences were examined at baseline and one-year post-baseline. A structural path model was used to examine if willingness mediated the effects of personality on consequences. Baseline drinking was included as a covariate in the model. Results demonstrated willingness to experience consequences significantly mediated the effects of impulsivity, sensation seeking, and self-regulation on consequences. Findings from this study support the idea that consequence-specific cognitions, such as willingness, can explain changes in consequences associated with personality. This suggests that intervention efforts aimed at reducing negative alcohol-related consequences could benefit from the inclusion of consequence-specific cognitions, personality (e.g., impulsivity, sensation seeking, and self-regulation), and drinking.

Patterns of Spiritual Connectedness during Adolescence: Links to Coping and Adjustment in Low-Income Urban Youth

Religiosity and spirituality are influential experiences that buffer adverse effects of stressors. Spirituality typically declines during adolescence, although not universally. Using Latent Class Growth Analysis, we examined changes in spiritual connectedness among 188 early (52% female; M age = 10.77, SD = 0.65 years) and 167 middle (56% female; M age = 13.68, SD = 0.82 years) predominantly African American adolescents participating in a 4-year longitudinal study. Three distinct profiles of spiritual connectedness emerged: low and steady, moderate with declines over the study period, and high and steady. Profile distributions varied across developmental level: there were more early adolescents in the high and steady profile and more middle adolescents in the decliner profile. Youth in the high and steady profile evidenced more goal-directedness and life satisfaction and more effective emotion management and coping strategies than youth in other profiles. Contributions to the positive development literature are discussed.

PTSD symptoms and alcohol-related problems among veterans: Temporal associations and vulnerability

Posttraumatic stress disorder (PTSD) is associated with elevated risk of both alcohol use disorder (AUD) and related conduct problems, which are associated with behavioral and emotional dysregulation. We conducted an intensive longitudinal burst design study with 10 weeks of experience sampling over the course of 1.5 years with 250 veterans of recent conflicts. We tested time-series models of daily associations between posttraumatic stress symptoms (PTSS), alcohol dependence syndrome, and conduct problems. Exacerbations of PTSS predicted higher dependence syndrome and conduct problems the next day. This effect was significant after controlling for both concurrent (i.e., same-day) associations between drinking and the outcomes as well as the strength of associations between the outcomes from one day to the next (i.e., autoregression). Affect lability and disinhibition were hypothesized vulnerability factors increasing the strength of within-person predictors of dependence syndrome and conduct problems. Lability and disinhibition were associated with greater dependence syndrome symptoms and conduct problems over the follow-up period. Consistent with expectation, lability rather than disinhibition increased the association between drinking and dependence syndrome as well as the strength of association between dependence syndrome symptoms from one day to the next. Moderating effects of disinhibition in the conduct problems model were not significant. Importantly, results indicated reciprocal associations over time. Lability potentiated the association between dependence syndrome symptoms and next day PTSS, whereas disinhibition potentiated the association between conduct problems and next day PTSS. Results demonstrate complex dynamic associations between PTSS, AUD symptoms, and conduct problems over time indicative of broad regulatory impairments. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

"R U Mad?": Computerized text analysis of affect in social media relates to stress and substance use among ethnic minority emerging adult males

OBJECTIVE

This study examined the interactive role of affectivity and stress in substance use severity among ethnic minority, emerging adult males, using linguistic indicators of affect obtained through social media.

METHOD

Participants were 119 emerging adult, ethnic minority males (ages 18-25) who provided access to their mobile phone text messaging and Facebook activity for 6-months. Computerized text analysis (LIWC2015) was used to obtain linguistic indices of positive and negative affect from texts and Facebook posts. The Perceived Stress Scale was used to measure stress, and items from the Drug Abuse Screening Test were used to measure substance use severity.

RESULTS

Generalized estimating equations showed that higher negative affect in texts was associated with greater substance use severity. Stress moderated the relationship between positive affect expressed in Facebook posts and substance use such that higher positive affect in Facebook posts was associated with less substance use at higher stress and greater substance use at lower stress.

CONCLUSIONS

Findings highlight the complexities of interactions between stress and affectivity. Findings could inform development of substance use interventions for young males that employ social technologies.

Becoming more or less mature? The decline of self-control in middle childhood

OBJECTIVE

This study examined the developmental change in self-control and its association with daily stressful events during middle childhood, as well as the factors that contribute to individual differences in the trajectory of self-control.

METHOD

A community sample of 302 Singaporean children (42% female, 69% Chinese) and their parents were recruited when the children were age 7. Follow-up assessments were made when the children were ages 8, 9, and 11. Developmental changes were examined using latent growth and autoregressive cross-lagged models.

RESULTS

Self-control showed a normative decline over time, and this trajectory was associated with an increase in daily stressful events. There was partial evidence for a reciprocal relationship between self-control and daily stressful events over time. Moreover, the child temperament dimension of effortful control (assessed at age 7) mitigated the decline in self-control, whereas low socioeconomic status predicted lower initial levels of self-control.

CONCLUSIONS

This study advances current understanding on the developmental change in self-control during middle childhood, as well as the factors that shape the direction and magnitude of this change.

Self-control demands and alcohol-related problems: Within- and between-person associations

This study tested a multilevel structural model of associations between two aspects of self-control (effortful control and reactivity), self-control demands, alcohol consumption, and alcohol problems and related risk behaviors using daily diary data from 196 young adults (4,177 person-days). Self-control demands were hypothesized to be positively associated with alcohol consumption and alcohol problems and related risk behaviors both within- and between-persons. At the between-person level, self-control demands were hypothesized to mediate the association between trait self-control and alcohol problems and related risk behaviors. At the within-person level, self-control demands had a direct positive effect on alcohol problems and related risk behaviors, over and above alcohol consumption. However, contrary to expectation, self-control demands were inversely associated with alcohol consumption. In contrast, self-control demands were positively associated with alcohol consumption at the between-person level and partially mediated the positive effects of reactivity on consumption and alcohol problems and related risk behaviors. That is, reactivity was associated with higher perceived self-control demands, which in turn predicted higher rates of consumption and alcohol problems and related risk behaviors. Effortful control was not significantly associated with alcohol consumption or self-control demands. The pattern of self-control demand effects at the within-person level suggest that young adults are less likely to drink when struggling to manage their day-to-day behavior, yet if they do drink they are more susceptible to negative consequences. Trait effects suggest that individual differences in self-control may be associated with alcohol use patterns in part attributable to development of, and response to, structured daily routines. (PsycINFO Database Record

Individualism-Collectivism, Social Self-Control and Adolescent Substance Use and Risky Sexual Behavior

Individualism and collectivism are cultural syndromes that have been associated with adolescent problem behavior in studies conducted in the U.S. and Southeast Asia. However, research investigating the mechanisms of how cultural orientation impacts health risk behaviors has been limited. This study tested a new model explaining the relationship between cultural orientation (i.e., individualism, collectivism) and adolescent problem behavior (i.e., substance use and risky sex) in terms of interpersonal self-regulation (i.e., social self-control). As such, the study is rooted in theories of the role of culture in developing self-regulation. Participants were high school students (N = 716) from the Bashkirtostan Republic of the Russian Federation. Adolescents from the Russian Federation tend to show high prevalence of cigarette smoking and binge drinking. People of the Russian Federation in general are traditionally collectivist in orientation, although increased globalization and post-Soviet capitalism may indicate high individualist values in younger generation Russians. Using path analysis we found that in addition to having direct effects, higher individualism indirectly affected substance use and risky sexual behavior through social self-control and negative life events. Higher collectivism was found to have a direct protective effect on risky sexual behavior and a direct effect on social self-control. However, collectivism was not found to have indirect effects on substance use or risky sexual behavior. Higher individualism appears to function as a risk factor for adolescent problem behavior and this relationship may be mediated by lower social self-control. Culturally-tailored prevention programs utilizing the individualism-collectivism framework may benefit from addressing social self-control.

Reappraisal deficits promote craving and emotional distress among chronic pain patients at risk for prescription opioid misuse

Background: A subset of chronic pain patients misuse prescription opioids as a means of regulating negative emotions. However, opioid misuse may result in deficits in emotion regulation strategies like reappraisal by virtue of the deleterious effects of chronic opioid exposure. Aims: The aim of this study was to characterize differences in reappraisal use among chronic pain patients at risk for opioid misuse and those who report taking opioids as prescribed. Methods: A sample of 127 pain patients receiving chronic opioid analgesic pharmacotherapy were classified as at risk for opioid misuse (n = 62) or taking opioids as prescribed (n = 65) using the Current Opioid Misuse Measure (COMM). The Emotion Regulation Questionnaire (ERQ) characterized use of emotion regulation strategies including reappraisal and expressive suppression. Participants also reported levels of opioid craving, emotional distress, and pain severity. Results: Patients at risk for opioid misuse reported significantly less reappraisal use (M = 25.31, SD = 7.33) than those who reportedly took opioids as prescribed (M = 30.28, SD = 7.50), p<.001, but did differ with regard to suppression strategies. Reduced reappraisal use was associated with higher opioid craving and emotional distress that mediated the association between reappraisal deficits and opioid misuse risk. Further, there was a significant indirect effect of opioid misuse on emotional distress via reappraisal use. Discussion: Opioid misuse risk was associated with reduced use of reappraisal, which in turn was associated with dysregulated negative emotions and increased appetitive drive towards consuming opioids. Studying individual differences in emotion regulation may yield efficacious intervention and prevention approaches to stem the rising tide of the prescription opioid crisis.

Working memory moderates the association between perceived norms and heavy episodic drinking among college students

Heavy episodic drinking (4+/5+ drinks/occasion for females/males) is highly prevalent among college students and is influenced by social factors. Among these social risk factors, perceived peer drinking norms have been shown to significantly predict heavy episodic drinking across a number of studies. However, there is little known about which students may be most and least susceptible to these influences or why individual differences may moderate the impact of norms on heavy drinking. Recent work has suggested self-control may be an important individual difference factor in this regard. Working memory (WM) is a central component of self-control that has been shown to buffer the effect of social influence variables. This study examined whether WM, as measured by memory span tasks, moderates the relationship between perceived drinking norms and alcohol use among college students reporting one or more past month drinking occasions (n = 98). Hierarchical linear regression analyses were used to examine whether WM significantly moderated the relationship between perceived norms and heavy drinking episodes (HDEs) as well as number of drinking days in the past month. Analyses revealed a significant WM x norms interaction for both drinking indices. Simple slopes analyses suggested a buffering effect of WM as higher perceived norms predicted more HDEs and drinking days at low (-1SD) and mean WM scores but not high (+1SD) WM. These results suggest WM serves as a protective factor for the influence of norms such that individuals high in WM may be more able to inhibit the impact of norms on alcohol use.

The role of emotion regulation in childhood obesity: implications for prevention and treatment

Stress and negative emotions pose a major threat to public health, by increasing the risk of obesity. Since the management process for emotions (emotion regulation; ER) is developed in childhood, we present a novel conceptual framework model for the role of ER in the prevention and treatment of childhood obesity. A narrative review of the literature by electronic database search (MEDLINE, Web of Knowledge and Scopus) was conducted of observational and interventional/experimental literature on ER and obesity and the underlying concepts. We also present an overview of ER intervention techniques. Our model indicates that childhood ER is a link between stress and obesity. Stress along with ineffective ER leads to abnormal cortisol patterns, emotional eating, sedentary lifestyle, reduction of physical activity, and sleep problems. Simultaneously, a healthy lifestyle could show benefits on ER and in developing adaptive ER strategies. In the development of obesity and ER, parents also play a role. By contrast, effective ER skills decrease obesity-related unhealthy behaviour and enhance protective factors, which boost health. The literature contains some observational studies of children but very few intervention studies, most of which are pilot or on-going studies. In conclusion, encouraging effective ER could be a useful new approach for combating and treating childhood obesity. Future ER intervention studies are needed to confirm the validity of this model in children.

Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data

Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.

Emotional Regulation in Young Adults with Internet Gaming Disorder

People diagnosed with Internet gaming disorder (IGD) have been frequently reported to experience depression, anxiety, and hostility. Emotional regulation contributes to these mood symptoms. This study evaluated emotional regulation in subjects with IGD and examined relationships between emotional regulation, depression, anxiety, and hostility in young adults with IGD. We recruited 87 people with IGD and a control group of 87 people without a history of IGD. All participants underwent a diagnostic interview based on the IGD criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and they completed a questionnaire on emotional regulation, depression, anxiety, and hostility. We found that subjects with IGD were less likely to practice cognitive reappraisal and were more likely to suppress their emotions. Linear regression revealed the higher cognitive reappraisal and lower expressive suppression associated with depression, anxiety, and hostility among subjects with IGD. The emotional regulation strategies that characterize those with IGD could be contributing factors to the depression and hostility tendencies of these people. When treating patients with IGD, in addition to providing appropriate interventions to relieve depression and hostility, practitioners should effectively assess emotional regulation strategies and provide emotional regulation therapy to prevent a vicious cycle of negative emotions.

A reinforcement sensitivity model of affective and behavioral dysregulation in marijuana use and associated problems

This study tested a model linking sensitivity to punishment (SP) and reward (SR) to marijuana use and problems via affect lability and poor control. A 6-month prospective design was used in a sample of 2,270 young-adults (64% female). The hypothesized SP × SR interaction did not predict affect lability or poor control, but did predict use likelihood at baseline. At low levels of SR, SP was associated with an increased likelihood of abstaining, which was attenuated as SR increased. SP and SR displayed positive main effects on both affect lability and poor control. Affect lability and poor control, in turn, mediated effects on the marijuana outcomes. Poor control predicted both increased marijuana use and, controlling for use level, greater intensity of problems. Affect lability predicted greater intensity of problems, but was not associated with use level. There were few prospective effects. SR consistently predicted greater marijuana use and problems. SP however, exhibited both risk and protective pathways. Results indicate that SP is associated with a decreased likelihood of marijuana use. However, once use is initiated SP is associated with increased risk of problems, in part, due to its effects on both affect and behavioral dysregulation. (PsycINFO Database Record

Kā-HOLO Project: a protocol for a randomized controlled trial of a native cultural dance program for cardiovascular disease prevention in Native Hawaiians

Background

As a major risk factor for cardiovascular and cerebrovascular disease (CVD), hypertension affects 33% of U.S. adults. Relative to other US races and ethnicities, Native Hawaiians have a high prevalence of hypertension and are 3 to 4 times more likely to have CVD. Effective, culturally-relevant interventions are needed to address CVD risk in this population. Investigators of the Kā-HOLO Project developed a study design to test the efficacy of an intervention that uses hula, a traditional Hawaiian dance, to increase physical activity and reduce CVD risk.

Methods

A 2-arm randomized controlled trial with a wait-list control design will be implemented to test a 6-month intervention based on hula to manage blood pressure and reduce CVD risk in 250 adult Native Hawaiians with diagnosed hypertension. Half of the sample will be randomized to each arm, stratified across multiple study sites. Primary outcomes are reduction in systolic blood pressure and improvement in CVD risk as measured by the Framingham Risk Score. Other psychosocial and sociocultural measures will be included to determine mediators of intervention effects on primary outcomes. Assessments will be conducted at baseline, 3 months, and 6 months for all participants, and at 12 months for intervention participants only.

Discussion

This trial will elucidate the efficacy of a novel hypertension management program designed to reduce CVD risk in an indigenous population by using a cultural dance form as its physical activity component. The results of this culturally-based intervention will have implications for other indigenous populations globally and will offer a sustainable, culturally-relevant means of addressing CVD disparities.

Trial registration

ClinicalTrials.gov: NCT02620709, registration date November 23, 2015.

PTSD, alcohol dependence, and conduct problems: Distinct pathways via lability and disinhibition

This study tested the role of affect lability and disinhibition in mediating associations between PTSD symptoms and two forms of alcohol-related problems, dependence syndrome symptoms (e.g., impaired control over consumption) and conduct problems (e.g., assault, risk behaviors). Genotype at the serotonin transporter linked polymorphic region (5-HTTLPR) was hypothesized to moderate associations between traumatic stress and PTSD symptoms. In addition, the study tested whether childhood traumatic stress moderated associations between combat trauma and PTSD symptoms. Participants were 270 OIF/OEF/OND veterans. The hypothesized model was largely supported. Participants with the low expression alleles of 5-HTTLPR (S or L_G) exhibited stronger associations between childhood (but not combat) traumatic stress and PTSD symptoms. Affect lability mediated the associations between PTSD symptoms and alcohol dependence symptoms. Behavioral disinhibition mediated associations between PTSD symptoms and conduct related problems. Conditional indirect effects indicated stronger associations between childhood traumatic stress and lability, behavioral disinhibition, alcohol consumption, AUD symptoms, and associated conduct problems via PTSD symptoms among those with the low expression 5-HTTLPR alleles. However, interactions between combat trauma and either childhood trauma or genotype were not significant. The results support the hypothesis that affect lability and behavioral disinhibition are potential intermediate traits with distinct associations with AUD and associated externalizing problems.