A meta-analysis of longitudinal associations between substance use and interpersonal attachment security

Do insecure adult attachment styles mediate the relationship between childhood maltreatment and violent behavior?

Attachment theory has played an important role in attempts to understand the "cycle of violence," where maltreated children are at increased risk for perpetrating violence later in life. However, little is known empirically about whether adult attachment insecurity in close relationships may partly explain the link between childhood maltreatment and violent behavior. This study aimed to address this gap using data from a prospective longitudinal study of documented childhood abuse and neglect cases and demographically matched controls (ages 0-11 years), who were followed into adulthood and interviewed (N = 892). Participants completed the Relationship Scales Questionnaire assessing adult attachment styles at mean age 39.54. Criminal arrest data were used to determine arrests for violence after the assessment of attachment through mean age 50.54. There were significant direct paths from childhood maltreatment and adult attachment insecurity to violent arrests after attachment measurement. Attachment insecurity partly explained the higher levels of violence in individuals with maltreatment histories. Analyses of maltreatment subtypes and attachment styles revealed that attachment anxiety appeared to mediate paths between neglect and physical abuse and later violence. There were no significant indirect paths from neglect or physical abuse to violence via attachment avoidance. Implications and future directions are discussed.

Heavy episodic drinking in adolescence and alcohol-related problems in adulthood: A developmental approach to alcohol use across the life course

Heavy episodic drinking (HED) is a major public health concern, and youth who engage in HED are at increased risk for alcohol-related problems that continue into adulthood. Importantly, there is heterogeneity in the onset and course of adolescent HED, as youth exhibit different trajectories of initiation and progression into heavy drinking. Much of what is known about the etiology of adolescent HED and alcohol-related problems that persist into adulthood comes from studies of predominantly White, middle-class youth. Because alcohol use and related problems vary by race/ethnicity and socioeconomic status, it is unclear whether previous findings are relevant for understanding developmental antecedents and distal consequences of adolescent HED for minoritized individuals. In the current study, we utilize a developmental psychopathology perspective to fill this gap in the literature. Using a racially and economically diverse cohort followed from adolescence well into adulthood, we apply group-based trajectory modeling (GBTM) to identify patterns of involvement in HED from age 14 to 17 years. We then investigate developmental antecedents of GBTM class membership, and alcohol-related distal outcomes in adulthood (∼ age 31 years) associated with GBTM class membership. Results highlight the importance of adolescent alcohol use in predicting future alcohol use in adulthood.

The robust reciprocal relationship between loneliness and depressive symptoms among the general population: Evidence from a quantitative analysis of 37 studies

BACKGROUND

Loneliness has long been associated with depressive symptoms, but there is no evidence on the question of "which comes first". To help us to answer this question, this study conducted a meta-analysis using a cross-lagged formula to examine the reciprocal relations between loneliness and depressive symptoms, as well as potential moderators.

METHODS

The meta-analytic dataset consisted of 37 studies with sample sizes ranging from 52 to 5991. Effect sizes (including autoregressive effects and lagged coefficients) were included. We computed weighted mean effect sizes for the correlation effect and cross-lagged effect between loneliness and depressive symptoms. We also performed a meta-regression to investigate potential moderators.

RESULTS

The results showed that loneliness and depressive symptoms reciprocally predicted each other over time with similar effect sizes. There was no moderation of our overall effect size in either direction by time interval between measurements, the proportion of female participants, mean age of the sample, or type of measurement.

LIMITATIONS

Caution should be taken in drawing final conclusions about the relative strength of reciprocal effects between loneliness and depressive symptoms due to the potential influence of varied research focus in the included studies, which could affect the effect size.

CONCLUSIONS

These findings advance the study of the relationship between loneliness and depressive symptoms by providing evidence that the link between them is symmetrically reciprocal and robust, which may help clinicians to develop effective intervention methods.

The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence

Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.

Support-Seeking and Active Coping Mitigate the Association Between Posttrauma Symptom Severity and Attachment Insecurity in a Community Sample of Trauma Survivors

There is an established association between posttrauma symptom severity (PTSS) and attachment insecurity (anxiety and avoidance). However, few studies have examined this association among community samples of trauma-exposed individuals and identified factors that might moderate these associations. We sought to (a) replicate existing associations between PTSS and attachment insecurity in a community sample of trauma survivors and (b) determine the potential moderating role of support-seeking and coping behaviors. Our sample included 824 trauma-exposed individuals (MPCL-5 = 31.6, SD = 20.0; Mage = 37.4, SD = 13.2; 69.3% female; 79.1% White; 77.2% heterosexual). Participants completed an online survey via Amazon Mechanical Turk. Linear regression and moderation analyses tested the association between PTSS and attachment insecurity and whether support-seeking and coping behaviors moderated these associations. PTSS was positively associated with global attachment anxiety (β = .48, 95% confidence interval [.42, .54]) and global attachment avoidance (β = .06, [.15, .29]). The association between PTSS and attachment avoidance was weaker for people who reported greater instrumental and emotional support-seeking or greater active coping. This study provides evidence for the association between PTSS and attachment insecurity. Findings underscore the need to understand causal mechanisms underlying this association and critically evaluate how existing and future interventions can buffer attachment insecurity in trauma-exposed individuals.

Mediating role of splitting in relation to attachment styles and shopping addiction

Introduction

Shopping can provide a sense of satisfaction and pleasure; however, if a person's excessive involvement in this behavior starts to negatively impact other aspects of their life, similar to other addictive behaviors like excessive internet use, gaming, and gambling, it may be classified as pathological. Given the lack of agreement regarding the classification of excessive shopping tendencies as a separate mental health condition or addictive behavior, taking a socio-emotional approach to explore the psychological factors that precede this behavior, may offer a better comprehension of it.

Methods

The purpose of this study was to examine the relationship between attachment styles and excessive shopping behavior, as well as to investigate the potential mediating effect of defense mechanisms like splitting on this relationship. Using convenience sampling, a group of 457 stock market employees (116 female, 341 male) between the ages of 24 and 60 were recruited. The researchers utilized a set of validated psychological questionnaires to assess the employees attachment styles, shopping addiction, and splitting tendencies.

Results

The results obtained from both the mediation model and path analysis suggest that attachment styles do not have a direct relationship with shopping addiction. Nonetheless, the study supports the impact of insecure anxious and avoidan attachment styles on splitting. Furthermore, the findings confirm that splitting has a mediating effect on the relationship between attachment styles and splitting.

Discussion

The present study enhanced our comprehension of the subconscious mechanisms underlying shopping tendencies. Specifically, the findings suggest that excessive tendencies towards shopping can be considered a maladaptive response resulting from insecure attachment styles and the unconscious utilization of the splitting defense mechanism.

Stimulant Use Associated With Psychosocial Factors, HIV Risk, and Concurrent Hazardous Alcohol Use Among US Adults: Exploratory Cross-Sectional Questionnaire Study

BACKGROUND

Stimulant use is a major public health problem that contributes to morbidity and mortality among men who have sex with men (MSM) in the United States. To reduce the harms associated with stimulant use, there is a need to identify the factors associated with stimulant use to inform interventions. Additionally, there is a need to use large crowdsourcing platforms like Amazon Mechanical Turk (MTurk) to engage more individuals who use substances across the United States.

OBJECTIVE

We identified the correlates of stimulant use among people who use alcohol or stimulants in the United States recruited using MTurk.

METHODS

Participants who were aged ≥18 years in the United States and reported alcohol or stimulant (ie, cocaine, crack cocaine, and methamphetamine) use were deemed eligible and recruited via the web platform MTurk. Participants completed a baseline survey, which assessed sociodemographics, psychosocial (ie, depression, affect, self-esteem, and stress) factors, substance use, and sexual behaviors. Data were collected and analyzed with STATA (version 17; StataCorp). Stratifying by MSM status, bivariate and multivariable logistic regression models were built in STATA to examine the correlates of stimulant use. Multivariable models controlled for age, race, health insurance, and relationship status.

RESULTS

Of 272 participants, 201 (73.9%) identified as male, 134 (49.2%) were MSM, 52 (19.1%) were from racial and ethnic minoritized communities, and 158 (58%) were in a relationship. The mean age was 36.10 (SD 10.3) years. A total of 40 (14.7%) participants reported stimulant use in the past 6 months. Factors significantly associated with stimulant use were being MSM (adjusted odds ratio [aOR] 4.61, 95% CI 1.97-10.81), a higher Alcohol Use Disorders Identification Test-Concise score (aOR 1.24, 95% CI 1.08-1.42), more intense cravings for alcohol in the past 24 hours (aOR 1.03, 95% CI 1.01-1.04), a higher depression score (aOR 1.06, 95% CI 1.01-1.12), a greater number of male partners in the last 6 months (aOR 1.32, 95% CI 1.08-1.61), a greater number of female partners in the last 6 months (aOR 1.42, 95% CI 1.04-1.92), and being diagnosed with a sexually transmitted infection (eg, syphilis, gonorrhea, chlamydia, herpes simplex virus, human papillomavirus, and other) in the last 6 months (aOR 14.61, 95% CI 3.45-61.87). Additionally, there was a significant additive interaction between MSM status and negative affect, such that the impact of negative affect on stimulant use was significantly greater among MSM compared with non-MSM (relative excess risk due to interaction 0.085, 95% CI 0.037-0.13).

CONCLUSIONS

Interventions that address stimulant use should use evidence-based approaches that reduce negative affect, depression, and cravings for alcohol. Additionally, interventions should be customized for MSM populations.

Colombian Adolescents’ Perceptions of Violence and Opportunities for Safe Spaces Across Community Settings

During adolescence, access to safe environments is critical for healthy development. This study analyzed adolescents’ perceptions of safety in personal and public spaces in the semi-rural community of Santa Ana, Colombia on the Island of Barú (95.8% of inhabitants live in poverty). We used thematic analysis to explore adolescents’ experiences and reflections to identify the factors influencing their perception of safety across different community spaces. Four gender-segregated focus group discussions were held with 40 adolescents (20 male and 20 female) from ages 13 to 17 ( M = 14.4, SD = 1.2). Most of them self-identified as Black (86%). The more recurrent spaces in the adolescents’ conversations were the streets, the school, the local sports field, individual homes, and commercial sound system parties known as “Picos.” Adolescents perceived the school as the safest space, while the “Picos” were the most unsafe. The other spaces were considered mixed, meaning that their perceived safety shifts and depends on the presence of certain factors. These factors were risky behaviors, group affiliation, designated authority roles and the relevance of time. The authors discuss the importance of addressing the factors that inform adolescents’ safety perception, particularly within low resource settings cross-culturally.

Congruence couple therapy for alcohol use and gambling disorders with comorbidities (part I): Outcomes from a randomized controlled trial

A nonblinded randomized trial was conducted at two Canadian provincial outpatient addiction clinics that tested the effectiveness of a systemic congruence couple therapy (CCT) versus individual-based treatment-as-usual (TAU) on nine clinical outcomes: (1) primary outcomes-alcohol use and gambling, psychiatric symptoms, and couple adjustment; (2) secondary outcomes-emotion regulation, substance use, depression, post-traumatic stress symptoms, and life stress. Data of primary clients and partners (N = 46) were analyzed longitudinally across baseline, posttreatment (5 months), and follow-up (8 months). Alcohol use disorder (95%) and gambling disorder (5%) were in the severe range at baseline, and co-addiction was 27%. Psychiatric comorbidity was 100%, and 18% of couples were jointly addicted. Between-group comparison favored CCT in primary outcomes with medium-to-large effect sizes (Cohen's h = 0.74-1.44). Secondary outcomes were also significantly stronger for CCT (Cohen's h = 0.27-1.53). Within-group, for all primary outcomes, a significant proportion of symptomatic CCT clients and partners improved, converging with ANOVA results of large effect sizes (0.14-0.29). All secondary outcomes improved significantly in CCT with large effect sizes (0.14-0.50). TAU showed significant within-group improvement in alcohol use, other substance use, and life stress with large effect sizes (0.16-0.40). Primary clients and partners made largely equivalent improvement within CCT and within TAU. Results were triangulated with clients' satisfaction ratings and counselors' reports. Overall, significant within-group effects were detected for CCT both clinically and statistically and between-group difference favored CCT. Future trials are required to validate these promising findings.

Interactive associations between abstinence plans and romantic partner conflict and support with cigarette smoking

BACKGROUND

While most individuals who smoke cigarettes desire to quit, quit motivation can change daily and sustained abstinence is rarely achieved in quit attempts. Assessment of psychosocial factors that moderate associations between daily abstinence intentions and smoking behavior is necessary to inform effective cessation efforts.

METHODS

A secondary analysis was conducted using data from a 28-day ecological momentary assessment study among individuals who smoke and who were not actively planning a long-term quit attempt (N = 81 individuals; N = 1585 days). We examined main effect and interaction associations between primary predictors (daily abstinence plans and within- and between-person estimates of perceived romantic relationship conflict and support) and daily number of cigarettes smoked, as well as baseline emotion regulation difficulties as a moderator of these associations.

RESULTS

Smoking was reduced on days with an abstinence plan (β=-0.57,p<.001), especially among individuals with lower average levels of conflict (plan × between-person conflict interaction: β=0.98, p < .001), and higher average levels of support (plan × between-person support interaction: β=0.26, p < .001). Additionally, smoking was increased on days when participants had higher levels of conflict than usual (β=0.07, p < .01), but only on days when participants did not have a plan (plan × within-person conflict interaction:β=-0.10, p < .05). Emotion regulation difficulties did not moderate any associations.

CONCLUSION

This study adds to the literature on the influence of negative aspects of social experience on smoking behavior. Further, the present study underlines the importance of assessing the influence of both positive and negative aspects of - and within- and between-person differences in - social experiences.

The Effects of Adolescent Cannabis Use on Psychosocial Functioning: A Critical Review of the Evidence

Although observational studies have shown that adolescent cannabis use is associated with impairments in important psychosocial domains, including peer, romantic, and parent-child relationships, educational outcomes, adult socioeconomic status, and legal consequences, mechanisms underlying these associations remain largely unclear. Cannabis use may have a deleterious causal effect on functioning, but it is also possible the association may be due to reverse causation or confounding by shared vulnerability factors that account for both cannabis use in adolescence and concurrent and subsequent psychosocial impairment. Causally informative studies that delineate these possibilities, including research using epidemiologic samples and quasi-experimental designs, are critical to move the field forward.

Smartphone addiction, gender and interpersonal attachment: A cross-sectional analytical survey in Taiwan

Overview

Smartphone use has dramatically increased worldwide, contributing to a profound change in interpersonal interactions. They have become the primary medium of human interaction, and smartphone addiction, consequently, has become a modern-day reality. Recent research on smartphone addiction has provided diverse explanations regarding the correlation between gender and addiction. Therefore, this study aims to analyse the correlation and variance among smartphone addiction, gender and interpersonal attachment.

Methods

The participants included Taiwanese citizens and the questionnaires were randomly distributed; 1190 valid questionnaires (534 males, 656 females) were collected. Descriptive statistics were computed to observe the average value and standard deviation between interpersonal attachment and gender. Next, Spearman's ρ was conducted to interpret the correlation among smartphone addiction, gender and interpersonal attachment. Finally, the participants were divided into three groups based on their pre-determined level of smartphone addiction: high, moderate and low addictions. The Analysis of variance (ANOVA) was performed based on interpersonal attachment as the independent variable to determine any statistically significant difference among the three levels.

Results

There are four patterns of interpersonal attachment: secure, avoidant, dismissing and anxious attachments. The correlation analysis revealed a significant positive correlation between interpersonal attachment and smartphone addiction (p > 0.000), while revealing no relationship between gender and smartphone addiction or gender and interpersonal attachment. Additionally, the ANOVA indicated the difference was statistically significant in the groups of high and moderate addictions; no statistical significance was identified in the group of low addiction (p < 0.204).

Conclusion

This study revealed that there was no correlation between gender and smartphone addiction, but rather, a positive correlation between smartphone addiction and interpersonal attachment. This positive correlation suggests both high and moderate addiction groups display insecurity in their interpersonal attachment. Therefore, to lower the prevalence of unhealthy smartphone addiction, maintaining healthy interpersonal relationships is suggested.

The influence of members’ attachment style on group cohesion in substance use therapy groups

Group cohesion is an important factor in group therapy as it influences treatment outcomes and group processes. One’s attachment style has been found to impact experiences of group cohesion, however research into this relationship in substance use disorder (SUD) group treatment is lacking. This is of particular concern as insecure attachment presentations are more prevalent in this clinical population and group therapy is often treatment of choice. The current study sought to determine whether attachment style significantly predicted group cohesion. It also provided a qualitative exploration of factors that promote group cohesion in SUD group treatment. Participants (N = 38) attending a SUD therapy program completed self-report measures. Attachment avoidance was a significant negative predictor of positive bonding and positive working, and a significant positive predictor of negative relationships. Attachment anxiety was a significant negative predictor of negative relationships, however, unexpectedly did not significantly predict positive bonding or positive working. The current findings highlight the importance of group therapists tailoring group treatment to meet the attachment needs of individuals to promote a group therapy environment conducive to recovery.

Crystallin Mu in Medial Amygdala Mediates the Effect of Social Experience on Cocaine Seeking in Males but Not in Females

BACKGROUND

Social experiences influence susceptibility to substance use disorder. The adolescent period is associated with the development of social reward and is exceptionally sensitive to disruptions to reward-associated behaviors by social experiences. Social isolation (SI) during adolescence alters anxiety- and reward-related behaviors in adult males, but little is known about females. The medial amygdala (meA) is a likely candidate for the modulation of social influence on drug reward because it regulates social reward, develops during adolescence, and is sensitive to social stress. However, little is known regarding how the meA responds to drugs of abuse.

METHODS

We used adolescent SI coupled with RNA sequencing to better understand the molecular mechanisms underlying meA regulation of social influence on reward.

RESULTS

We show that SI in adolescence, a well-established preclinical model for addiction susceptibility, enhances preference for cocaine in male but not in female mice and alters cocaine-induced protein and transcriptional profiles within the adult meA particularly in males. To determine whether transcriptional mechanisms within the meA are important for these behavioral effects, we manipulated Crym expression, a sex-specific key driver gene identified through differential gene expression and coexpression network analyses, specifically in meA neurons. Overexpression of Crym, but not another key driver that did not meet our sex-specific criteria, recapitulated the behavioral and transcriptional effects of adolescent SI.

CONCLUSIONS

These results show that the meA is essential for modulating the sex-specific effects of social experience on drug reward and establish Crym as a critical mediator of sex-specific behavioral and transcriptional plasticity.

Validating transdermal alcohol biosensors: a meta-analysis of associations between blood/breath-based measures and transdermal alcohol sensor output

BACKGROUND AND AIMS

Transdermal alcohol sensors carry immense promise for the continuous assessment of drinking but are inconsistent in detecting more fine-grained indicators of alcohol consumption. Prior studies examining associations between transdermal alcohol concentration (TAC) and blood/breath alcohol concentration (BAC) have yielded highly variable correlations and lag times. The current review aimed to synthesize transdermal validation studies, aggregating results from more than three decades of research to characterize the validity of transdermal sensors for assessing alcohol consumption.

METHODS

Databases were searched for studies listed prior to 1 March 2022 that examined associations between transdermal alcohol sensor output and blood and breath-based alcohol measures, resulting in 31 primarily laboratory-derived participant samples (27 precise effect sizes) including both healthy and clinical populations. Correlation coefficients and lag times were pooled using three-level random-effects meta-regression. Independent raters coded study characteristics, including the body position of transdermal sensors (ankle- versus arm/hand/wrist-worn device) and methodological bias (e.g. missing data).

RESULTS

Analyses revealed that, in this primarily laboratory-derived sample of studies, the average correlation between TAC and BAC was large in magnitude [r = 0.87, 95% confidence interval (CI) = 0.80, 0.93], and TAC lagged behind BAC by an average of 95.90 minutes (95% CI = 55.50, 136.29). Device body position significantly moderated both TAC-BAC correlation (b = 0.11, P = 0.009) and lag time (b = -69.41, P < 0.001). Lag times for ankle-worn devices were approximately double those for arm/hand/wrist-worn devices, and TAC-BAC correlations also tended to be stronger for arm/hand/wrist-worn sensors.

CONCLUSIONS

This meta-analysis indicates that transdermal alcohol sensors perform strongly in assessing blood/breath alcohol concentration under controlled conditions, with particular promise for the newer generation of wrist-worn devices.

Problematic Gambling Behavior in a Sample with Substance Use Disorder: The Role of Attachment Style and Alexithymia

Gambling disorder is a high comorbid disorder in substance abusers which conjunct appearance is related to worse symptomatology and evolution. Nevertheless, the research on the risk factors that may explain this comorbidity is scarce. We build of the self-regulation theory of attachment and addiction to examine if insecure attachment is related to gambling comorbidity in substance abuse disorder and the mediating role of alexithymia in this process. A cross-sectional study was carried out with 369 clinical patients with substance use disorder of which 69 presented comorbid gambling disorder diagnosed with the DSM-5 criteria. Results showed that insecure attachment was more prevalent in the group with comorbid gambling. In this group, the alexithymia levels were also higher and mediated the relationship in between attachment and gambling disorder comorbidity even controlling for several sociodemographic variables. This research indicates that insecure attachment enhances the risk of gambling comorbidity on substance abusers due to the detrimental effect on the self-regulation of emotion. Thus, interventions directed to increase the identification, expression and awareness of emotions might help to reduce comorbidity of gambling of substance use disorders.

Relationship between insecure attachment and mobile phone addiction: A meta-analysis

OBJECTIVE

Many studies have explored the relationship between insecure attachment and mobile phone addiction from different theoretical perspectives; however, the results have been different. This meta-analysis aimed to explore the relationship between insecure attachment and mobile phone addiction.

METHODS

Studies published before November 2021 were identified through a systematic online search. A total of 22 studies, including 38 independent effect sizes were included from a systematic search of multiple databases, with a total sample size of 11,810 cases. Stata Version 16.0 was used for meta-analysis.

RESULTS

The meta-analysis based on random-effects model showed that mobile phone addiction was highly positively associated with attachment anxiety (r = 0.395, 95%CI [0.345, 0.442]) and weakly positively correlated with attachment avoidance (r = 0.194, 95%CI [0.137, 0.250]). The relationship between attachment anxiety and mobile phone addiction and that between attachment avoidance and mobile phone addiction were both moderated by mobile phone addiction measures but not moderated by gender and attachment measures.

CONCLUSION

There is a positive correlation between mobile phone addiction and insecure attachment. In the future, measures to prevent mobile phone addiction should focus on insecure attachment individuals and help them construct a healthy attachment relationship and secure attachment model.

Individual factors associated with the consumption of illicit substances: a review of reviews

INTRODUCTION

According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon.

METHODS

This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR.

RESULTS

Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders.

CONCLUSIONS

The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.

The Relationship between Boredom Proneness, Attachment Styles and Compulsive Sexual Behavior

Affect regulation is associated with compulsive sexual behavior (CSB) despite ongoing debate about its inclusion in diagnostic criteria. Previous studies on two specific affect regulation constructs - boredom proneness and attachment styles - suggest that affect regulation is associated with CSB. We tested a moderation model of the effects of attachment anxiety and attachment avoidance on the relationship between boredom proneness and CSB. Results indicate that the relationship between boredom proneness and CSB is stronger at higher levels of attachment anxiety, with no interaction between boredom proneness and attachment avoidance. Overall findings support the importance of affect regulation in conceptualizing and treating CSB.

Cross-Lagged Associations of Insecure Attachment Style, Alcohol Use, and Sexual Behavior During Emerging Adulthood

Insecure romantic attachment style has been associated with greater substance use and higher risk sexual behavior, but the temporal nature of these associations is not well-understood. This study examined whether having a more insecure attachment style was associated with greater engagement in higher-risk sexual behavior over time and, if so, whether this was mediated by more frequent alcohol use. We used three annual waves of survey data from a diverse California cohort (N = 2371) who were assessed from ages 19 to 21-22 years. Separate cross-lagged models examined temporal associations of insecure romantic attachment style (anxious and avoidant), past month alcohol use frequency, and sexual behavior (number of sex partners, condomless sex with casual and steady partners). Attachment anxiety was not directly associated with sexual behavior. Rather, a consistent pattern across waves showed that greater attachment anxiety was associated with more frequent alcohol use at the next wave, which, in turn, was associated with having more sex partners and condomless sex with casual and steady partners one year later. In contrast, greater attachment avoidance was directly associated with having fewer sex partners, and its associations with condomless sex differed across partner type and assessment waves. Attachment avoidance was unrelated to alcohol use frequency. Results indicated that both anxious and avoidant attachment styles were associated with higher-risk sexual behavior, but in different ways and through different mechanisms. Future research may want to examine whether the effectiveness of sexual risk reduction programs for young people is enhanced by discussing attachment style and tailoring the curriculum accordingly.

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.

Nonmedical Prescription Drug Use Among Female Adolescents: The Relative Influence of Maternal Factors, Social Norms, and Perceptions of Risk and Availability

Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examined using paired data from parents and adolescents. We aimed to examine the relative influence of these correlates among dyads (N=349) of mothers and adolescent daughters. Using multiple logistic regression, daughters' past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers' disapproval about use, mothers' past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers' inclination for NMUPD were risk factors for daughters' NMUPD, while a closer mother-daughter relationship and mothers' disapproving attitudes towards NMUPD were protective factors. The three analysis approaches were corroborative. Results suggest friend descriptive norms, mother-daughter relationship quality, and mothers' attitudes about NMUPD are important prevention targets.

Is high self-esteem beneficial? Revisiting a classic question

Debates about the benefits of self-esteem have persisted for decades, both in the scientific literature and in the popular press. Although many researchers and lay people have argued that high self-esteem helps individuals adapt to and succeed in a variety of life domains, there is widespread skepticism about this claim. The present article takes a new look at the voluminous body of research (including several meta-analyses) examining the consequences of self-esteem for several important life domains: relationships, school, work, mental health, physical health, and antisocial behavior. Overall, the findings suggest that self-esteem is beneficial in all these domains, and that these benefits hold across age, gender, and race/ethnicity, and controlling for prior levels of the predicted outcomes and potential third variable confounds. The meta-analytic estimates of self-esteem effects (which average .10 across domains) are comparable in size to estimates for other hypothesized causal factors such as self-efficacy, positive emotionality, attachment security, and growth mindset, and larger than some generally accepted pharmaceutical interventions. Discussion focuses on several issues that are critical for evaluating the findings, including the strength of the evidence for making causal inferences, the magnitude of the effects, the importance of distinguishing between self-esteem and narcissism, and the generalizability of the results. In summary, the present findings support theoretical conceptions of self-esteem as an adaptive trait that has wide-ranging influences on healthy adjustment and adaptation, and suggest that interventions aimed at boosting self-esteem might, if properly designed and implemented, benefit individuals and society as a whole. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Common Features in Compulsive Sexual Behavior, Substance Use Disorders, Personality, Temperament, and Attachment-A Narrative Review

Do addictions share common traits of an “addictive personality” or do different addictions have distinct personality profiles? This narrative review examines the differences in the associations between substance use disorder (SUD) and compulsive sexual behavior disorder (CSBD), on the one hand, and personality traits, attachment dispositions, and temperament, on the other hand. We found that both people with a SUD and people with CSBD tended to be more spontaneous, careless, and less reliable, to place self-interest above getting along with others, to show emotional instability and experience negative emotions such as anger, anxiety, and/or depression, to be less able to control their attention and/or behavior, and to be engulfed with a constant sensation of “wanting”. Only people with CSBD, but not SUD, noted concerns with their social ties, fear of losing close others, and/or trusting others around them. Results also suggested that people with a SUD and people with CSBD share high commonalities in personality traits and temperament, yet there are noted differences in their social tendencies, especially with close others. People with CSBD reported more concerns with possible relationship losses compared to people with SUD issues, who may be more worried about losing their source of escapism.

Self-Schema, Attachment Style, and Treatment Outcome of Patients in an Opiate Maintenance Treatment Unit

The aim of this study was to explore self-schemas and attachment style among patients in a methadone or buprenorphine maintenance treatment program of opiate dependence, in relation to treatment outcome (relapse in substance use). The study included 84 patients (21 women and 63 men) in a psychiatric clinic in Malmö, Sweden, providing maintenance treatment of opiate dependence. Three self-report instruments were employed, Young Schema Questionnaire Short version (YSQ-S) and Young Parenting Inventory (YPI) for studying self-schemas and Experiences in Close Relationships–Relationship Structures questionnaire (ECR-RS) for studying attachment style. Demographical data and relapse in substance abuse were registered. The study demonstrated, unsurprisingly, that an insecure attachment style was more common in the group of patients compared to available general population reference data. Significant correlations were found between attachment style and core beliefs about the self (self-schemas). Memories of parenting experiences from childhood (YPI) showed correlations with ongoing self-schemas (YSQ-S). Treatment outcome, defined as relapses in substance abuse, was associated to a minor degree with self-schemas but showed no correlation with attachment style. Patients who did not work or study had more maladaptive self-schemas and insecure attachment style, and a higher incidence of relapse in abuse than patients who were working or studying.

Early-life maternal attachment and risky health behaviours in adolescence: findings from the United Kingdom Millennium Cohort Study

Background

Early uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study.

Methods

Total maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years.

Results

Children of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting for all factors (30%).

Conclusions

Lower maternal attachment in early life predicted increased adolescent multiple risky behaviours. Almost a third of the excess risk was attributable to child, maternal and socioeconomic factors, with over a quarter explained by maternal depression. Recognising the influence of early-life risk factors on adolescent health could innovate current policies and interventions addressing multiple risky behaviour uptake affecting health inequalities across the life course.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12141-5.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.

The role of attachment, coping style and reasons for substance use in substance users with psychosis

Seventy substance users with psychosis who were participating in a clinical trial of a psychological therapy for psychosis were additionally assessed for attachment, coping styles and self-reported reasons for substance use in order to test a hypothesized sequential mediation model. In this model the relationship between insecure attachment and problematic substance use was assumed to be sequentially mediated by dysfunctional coping and the use of substances to cope with distress. Hypothesized associations between insecure-avoidant attachment and substance use were not supported, but the relationship between insecure-anxious attachment and problematic substance use was confirmed and found to be fully mediated by dysfunctional coping and coping reasons for use. Findings suggest that fostering secure attachments in people with psychosis might promote more successful coping and could prevent or reduce substance use related problems in this group.

A Grounded Theory Study: How Non-Treatment-Seeking Substance Users Make Sense of Their Behaviour “I Want To Be Me but I Don’t Know Who Me Is”

Despite the global impact of substance misuse, there are inadequate levels of specialist service provision and continued difficulties with treatment engagement. Within policy and research, there is substantial consideration of the importance of these factors. However, there is little empirical evidence of the views of non-treatment-seeking substance users, who make up the majority of the substance using population. The aim of this study was to understand how these individuals make sense of their behaviour and their reasons for not accessing treatment. A constructivist grounded theory approach was used to interview eight individuals who were currently using substances and not seeking help to stop. The analysis highlighted the importance of attachment to an identity associated with substance use, and relational variables such as connectedness to others, for treatment decisions for individuals who use substances. Understanding these influences, through trauma- and attachment-informed service provision, may reduce barriers to help-seeking and improve treatment uptake.

The Roles of Attachment Style, Self-Efficacy, and Impulsivity on the Prediction of Attitudes toward Substance Use in Male Adolescents

The aim of this study was to examine the role of attachment styles, self-efficacy, and impulsivity on the prediction of attitudes toward substance abuse among male adolescents. Participants were 199 male adolescents from Najafabad City, Isfahan province, Iran. A demographic questionnaire, the Attachment Style Measure (ASM), the General Self-Efficacy Scale (GSES), the Barratt Impulsiveness Scale (BIS), and the Attitude toward Substance Use Scale (ASUS) were used in this study. Analysis showed that avoidance and ambivalent attachment patterns and impulsiveness were significantly positively correlated with attitudes toward substance use. On the other hand, secure attachment style and self-efficacy were significantly negatively associated with attitudes toward substance use. Findings showed that attachment styles, self-efficacy, and impulsiveness account for 58% of the variance in attitudes toward substance use among these adolescents. This study confirmed the predictive role of attachment styles, self-efficacy, and impulsivity in the prediction of the attitudes toward substance use in male adolescents.

Adopted children who kill their adoptive parents: An examination through the lens of attachment theory

Adoptive parricide, the killing of adoptive parents by their adoptive children, is a phenomenon that garners much media attention but remains elusive in the extant literature. Previous studies on adoptive parricide have largely consisted of clinical case studies with limited theoretical explanations. The current study uses Bowlby's attachment theory as a theoretical framework to explore adoptive parricide. A content analysis was conducted of news sources to obtain data on adoptive parricide cases. Hypotheses were generated per attachment theory in the context of Heide's (2013b) parricide offender typology. Early adoptees (n = 27) were compared to late adoptees (n = 29) using Fisher's exact tests. Early adoptees were more likely to kill multiple victims, kill for selfish motives, be overindulged by adoptive parents, and not have limits set and enforced by adoptive parents. Late adoptees were more likely to report having been abused by their adoptive parents. The results were not consistent with attachment theory. Implications for the adoption process and adoptive parenting practices are presented.

The Relationship between Drug Consumption and Dating App Use: Results from an Italian Survey

To date, the literature regarding the relationship between drug consumption and dating app use is still very scant and inconclusive. The present study was thus aimed at investigating the association between drug consumption and dating app use in the general population. A total of 1278 Italian respondents completed an online ad hoc questionnaire assessing drug consumption (cannabis versus other illicit drugs), dating app use, the primary motive for installing dating apps, and demographics. Multiple logistic regression analyses were run to investigate the role of demographics and dating app use on drug consumption. Being single predicted cannabis use. Using dating apps accounted for higher odds of cannabis use; however, people who intensely used the apps were less likely to consume marijuana. Conversely, dating app use was not associated with the consumption of other drugs. This study suggests the presence of common underlying factors between dating app use and cannabis use, and it highlights the mediating role of the intensity of app use. Conversely, the study suggests that dating app use and the use of other drugs are quite independent behaviors.

Work Experiences and Self-Esteem Development: A Meta-Analysis of Longitudinal Studies

Theory suggests that people’s work experiences influence their self-esteem and, vice versa, that self-esteem influences work experiences. This meta-analysis of longitudinal studies synthesizes the available evidence on prospective effects between work experiences and self-esteem, controlling for prior levels of the outcomes. The following work variables were examined: job satisfaction, job success, income, job resources, job stressors, and employment status. The analyses were based on 30 independent samples, including data from 53,112 participants. Mean age ranged from 17 to 64 years, spanning most of the work life. For each work variable, we computed random-effects models with standardized regression coefficients as effect size measure. Results suggested reciprocal effects between work experiences and self-esteem. The effects of self-esteem on later work experiences (point estimates ranged from .05 to .10) were slightly larger than the effects of work experiences on later self-esteem (point estimates ranged from .02 to .05). Moderator analyses on the relation between job satisfaction and self-esteem indicated that the effects did not differ across age, gender, sample type, and time lag. Overall, the findings support the corresponsive principle of personality development and suggest that the work domain and people’s self-esteem are interdependent.

Attachment anxiety as mediator of the relationship between childhood trauma and personality dysfunction in borderline personality disorder

Insecure attachment has been described as mediating the relationship between childhood trauma and dysfunctional personality traits in different mental disorders. Despite the role insecure attachment and childhood trauma have independently demonstrated to play as determinants of borderline personality disorder, less is known about the mediating mechanisms explaining these associations. For the first time, we assessed adult attachment, childhood trauma and dimensional personality pathology in a sample of outpatients with borderline personality disorder and tested whether the association between childhood trauma and personality dysfunction was at least partially attributable to insecure attachment. The results showed that attachment anxiety fully mediated the relationship between specific types of trauma (emotional abuse and physical neglect) and emotional dysregulation. Further, emotional abuse was both directly associated with dissocial behaviour and indirectly via attachment anxiety (partial mediation). Emotional abuse has been described as an essential environmental factor for the development of borderline personality disorder and emotional dysregulation, on its part, as the core feature of the condition. Our results indicate that attachment anxiety explains the link between these central aspects of borderline personality disorder. Our findings are consistent with previous research and current etiological understanding of the condition and provide support for recommending a careful assessment of childhood traumatic experiences and adult attachment style to gain a more comprehensive insight into the symptoms and its heterogeneity. As a secondary aim, we assessed the effect parental mental illness may have in these mediation models, but no significant influence on childhood trauma, attachment or personality was found.

Alcohol and Neural Dynamics: A Meta-analysis of Acute Alcohol Effects on Event-Related Brain Potentials

BACKGROUND

An understanding of alcohol's acute neural effects could augment our knowledge of mechanisms underlying alcohol-related cognitive/motor impairment and inform interventions for addiction. Focusing on studies employing event-related brain potential methods, which offer a direct measurement of neural activity in functionally well-characterized brain networks, we present the first meta-analysis to explore acute effects of alcohol on the human brain.

METHODS

Databases were searched for randomized laboratory alcohol-administration trials assessing brain activity using event-related potentials. Hedges' g coefficients were pooled using 3-level random-effects meta-regression.

RESULTS

Sixty independent randomized controlled trials met inclusion (total N = 2149). Alcohol's effects varied significantly across neural systems, with alcohol leading to reductions in event-related potential components linked with attention (P3b), g = -0.40, 95% CI (-0.50, -0.29), automatic auditory processing (mismatch negativity), g = -0.44, 95% CI (-0.66, -0.22), and performance monitoring (error-related negativity), g = -0.56, 95% CI (-0.79, -0.33). These effects were moderated by alcohol dose, emerging as significant at doses as low as 0.026% blood alcohol concentration and increasing to moderate/large at 0.12%. In contrast, irrespective of dose, relatively small or nonsignificant alcohol effects emerged in other processing domains, including those linked to executive control (N2b responses) and stimulus classification (N2c responses).

CONCLUSIONS

Contrary to traditional conceptualizations of alcohol as a "dirty drug" with broad central nervous system depressant effects, results instead support accounts positing targeted alcohol effects in specific processing domains. By identifying alcohol effects on brain systems involved in performance monitoring and attention, results move toward the identification of mechanisms underlying alcohol-related impairment as well as factors reinforcing addiction.

Social support and posttraumatic stress disorder: A meta-analysis of longitudinal studies

Social support has long been associated with posttraumatic stress disorder (PTSD), but there is no consistent evidence on the strength and direction of this relationship. Whereas the social causation model claims that social support buffers against PTSD, the social selection model states that PTSD reduces social support resources. As the first meta-analysis of the prospective relationships between social support and PTSD, this study synthesized the available longitudinal data (75 samples including 32,402 participants) on these two constructs with a random-effects model. In total, three hundred and fifty-five effect sizes (including cross-sectional, prospective and cross-lagged coefficients) were included in the meta-analysis. With prior levels of the relevant outcomes controlled for, results showed that social support and PTSD reciprocally predicted each other over time with similar effect sizes: Social support predicted PTSD with β = -0.10; PTSD predicted social support with β = -0.09. Moderator analyses suggested that the effects held across most sample characteristics and research designs except for several moderators (gender, time lag, publication year, source of support). These findings provided strong evidence for both the social causation and social selection models, suggesting that the link between social support and PTSD is symmetrically reciprocal and robust.

Intertwined associations among attachment styles, emotional dysregulation, and ADHD: examining unique associations with general risk-taking behavior

Attachment insecurity, emotional dysregulation, and attention-deficit/hyperactivity disorder (ADHD) have all been implicated across the literature with various forms of negative life outcomes and increased risk-taking behavior (RTB). Furthermore, abundant research has demonstrated that the three seem to go together. Given these intercorrelations, it is unclear if any of them possess exclusive links with RTB independent of the others across multiple life domains. The present study examined the relations among attachment styles, emotional dysregulation, ADHD symptoms, and hypothetical RTBs across multiple real-life domains. Including a total of 155 mostly undergraduate students, we found in the main analysis that only ADHD symptoms were associated with RTB over and above all other variables. Specifically, the links between both attachment insecurity and emotional dysregulation with RTB disappeared when ADHD symptoms were included in the final model, but not vice versa. An exploratory analysis suggested that attachment insecurity was linked to romantic/sexual RTB over and above the others. These results further substantiate the link between ADHD symptoms and a general propensity for RTB and demonstrate that the link between the two seems to be inherent to the disorder and independent of its co-occurrence with attachment insecurity and emotional dysregulation.

Effects of psychotherapy on comorbid bipolar disorder and substance use disorder: A systematic review

OBJECTIVES

This review aim was to examine whether psychotherapy is more or less effective in patients with SUD, compared to those without; whether there is a differential effect of a particular psychotherapy in patients with SUD.

METHODS

A quantitative systematic review following the Cochrane Handbook of Systematic Reviews was used.

RESULTS

Five studies of psychotherapy for BD and two studies of an integrated psychotherapy for comorbid BD and SUD were included in the review. Five studies provided a sub-analysis of the effect of SUD on overall outcomes with only one finding an overall detrimental effect. The results indicated equal, if not better outcomes for individuals with comorbid BD and SUD.

CONCLUSION

There was little evidence that interventions targeted at both BD and SUD may be more efficacious. Further research in to psychotherapeutic treatment for BD should include individuals with comorbid SUD, and analyse substance use as an outcome. Additionally, research into treatments specifically developed for these commonly comorbid disorders is indicated.

Difficult binds: A systematic review of facilitators and barriers to treatment among mothers with substance use disorders

BACKGROUND

The United States and Canada have observed sharp increases in substance use disorder among women of child-bearing or child-rearing age. Substance use disorder can have deleterious effects on children, families, and communities. Many evidence-based treatments exist, but engaging mothers in treatment is difficult. No recent review is available to help systems and providers understand the facilitators of and barriers to treatment for mothers.

OBJECTIVE

To systematically identify facilitators and barriers to substance use and mental health treatment for mothers with substance use disorder who are pregnant or parenting young children in the United States and Canada.

METHODS

We systematically searched the literature using five online databases and performed a gray literature search. We included studies published in the past two decades focused on parent or provider perspectives.

RESULTS

Our search identified 23 high-quality papers. The majority of papers qualitatively examined the perspectives of treatment-seeking pregnant women and mothers diverse in race/ethnicity, region, and treatment settings. Our synthesis of findings revealed the compelling and complex centrality of motherhood, which served as both a facilitator and barrier. Motherhood often interacted with relational (e.g., perceiving stigma vs. support from providers, family, friends, partners) and structural (e.g., time commitments, childcare) factors to both hinder and help engagement in treatment.

CONCLUSIONS

Our findings can help policy-makers and practitioners make tangible improvements to the financing and delivery of substance use treatment for mothers. Our review points to specific areas for future research, including an examination of the relationships between various structural factors and treatment outcomes.

Women in Christian Substance Abuse Treatment; Forgiveness, Attachment Styles, and Improvements in Co-occurring Mental Health Symptoms

The purpose of this study was to explore the efficacy of The Recovery Center at Shalom House Ministries and examine the relationship(s) between forgiveness, attachment styles, drug and alcohol abuse, self-reported mental health symptoms, and cognitive functioning. Participants (N = 118 women) attended Shalom Recovery (2016-2018). Statistically significant improvement was found between entrance and the 3-month mark on all measures, with 67.9% completing the program. Findings indicated that the revenge motivations correlated with depression, self-esteem, anxiety, and avoidance of intimacy with God, but only this latter scale contributed to a multiple regression model on revenge motivations at program entry.

Parent-adolescent relationship characteristics and adolescent cannabis use: A growth curve analysis

Background: Adolescent cannabis misuse may be associated with serious academic, conduct, and health problems. Identifying factors associated with adolescent cannabis misuse over time may provide insight to address these factors in interventions. Parent-adolescent relationship characteristics (i.e., attachment, discipline) have been linked to adolescent cannabis misuse and may be important factors to study. Objectives: We investigated time-varying associations between parent-adolescent relationship domains and weekly adolescent-reported cannabis misuse. We hypothesized that during times when parents reported less positive aspects of their relationship with their adolescents, adolescents would report higher levels of cannabis misuse. Methods: Data were drawn from a community clinic treatment study for adolescents with substance use and co-occurring psychiatric disorders (n=110; average age=15.71; 57.3% male). Latent growth modeling with time-varying predictors (parent-adolescent relationship characteristics) was used to examine if the associations between adolescent cannabis misuse and relational frustration, discipline, and attachment varied across the study period (baseline, 3-, 6-, and 12-months). Results: Weekly cannabis misuse significantly increased over time, even after accounting for parental relationship characteristics. When parents rated higher levels of relational frustration relative to their average level of frustration, adolescents reported higher cannabis misuse at all study periods except 12-month follow-up. Conclusion: Results support the importance of considering how specific aspects of the parentadolescent relationship, in this case elevated parental frustration, are associated with adolescent cannabis misuse during treatment and after its completion. Findings suggest parental relationship frustration is a key factor to assess and address within individually tailored interventions for co-occurring cannabis misuse and psychiatric disorders.