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Kearns NT, Trachik B, Fawver B, Osgood J, Dretsch MN. Alcohol motivations associated with frequency of alcohol use, binge drinking, and alcohol problems among active duty junior enlisted soldiers and non-commissioned officers. Alcohol 2024; 115:23-31. [PMID: 37684009 DOI: 10.1016/j.alcohol.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/15/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
Problematic alcohol use is a serious threat to the behavioral health of active-duty Service Members (ADSM), resulting in numerous calls from governmental agencies to better understand mechanistic factors contributing to alcohol misuse within the military. Alcohol use motives are reliable predictors of alcohol-related behaviors and are considered malleable targets for prevention and intervention efforts. However, empirical research indicates that drinking motives vary across contextually distinct populations. Although some research has been conducted among veteran and reservist populations, limited work has been specifically focused on ADSM and no research has evaluated motives and alcohol metrics among ADSM based on military rank. Participants for the current study included 682 ADSM recruited from a large military installation in the U.S. Structural equation modeling evaluated associations between four drinking motives (i.e., enhancement, social, conformity, coping) and three alcohol misuse metrics (i.e., alcohol frequency, binge frequency, alcohol problems). Three models were evaluated: one full (combined) model and two separate models based on military rank - junior enlisted (i.e., E1-E4) and non-commissioned officers (NCOs) (i.e., E5-E9). Results for junior enlisted ADSM indicated that coping and enhancement motives were most strongly associated with all alcohol misuse metrics. However, among NCOs, results indicated that alcohol problems were only associated with coping motives. Notably, results also indicated that alcohol use motives accounted for substantively more variance across all alcohol-related metrics among NCOs. Findings generally support extant military-related literature indicating use of alcohol for coping (e.g., with anxiety) as the motivation most consistently associated with increased alcohol misuse. However, novel findings highlight enhancement motives - using alcohol to attain some positive internal reward - as another, often stronger, motivation impacting alcohol use outcomes. Further, findings highlight notable distinctions between alcohol use motives (i.e., coping vs. enhancement) and the impact of alcohol use motives (i.e., effect size) on alcohol metrics between junior enlisted and NCOs.
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Affiliation(s)
- Nathan T Kearns
- Walter Reed Army Institute of Research - West (WRAIR-W), 9933A W. Johnson St., Joint Base Lewis-McChord, Washington, United States.
| | - Benjamin Trachik
- Walter Reed Army Institute of Research - West (WRAIR-W), 9933A W. Johnson St., Joint Base Lewis-McChord, Washington, United States
| | - Bradley Fawver
- Walter Reed Army Institute of Research - West (WRAIR-W), 9933A W. Johnson St., Joint Base Lewis-McChord, Washington, United States
| | - Jeffrey Osgood
- Walter Reed Army Institute of Research - West (WRAIR-W), 9933A W. Johnson St., Joint Base Lewis-McChord, Washington, United States
| | - Michael N Dretsch
- Walter Reed Army Institute of Research - West (WRAIR-W), 9933A W. Johnson St., Joint Base Lewis-McChord, Washington, United States
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Caumiant EP, Fairbairn CE, Bresin K, Gary Rosen I, Luczak SE, Kang D. Social anxiety and alcohol consumption: The role of social context. Addict Behav 2023; 143:107672. [PMID: 36905792 PMCID: PMC10122700 DOI: 10.1016/j.addbeh.2023.107672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 03/02/2023]
Abstract
Research has identified social anxiety as a risk factor for the development of alcohol use disorder. However, studies have produced equivocal findings regarding the relationship between social anxiety and drinking behaviors in authentic drinking environments. This study examined how social-contextual features of real-world drinking contexts might influence the relationship between social anxiety and alcohol consumption in everyday settings. At an initial laboratory visit, heavy social drinkers (N = 48) completed the Liebowitz Social Anxiety Scale. Participants were then outfitted with a transdermal alcohol monitor individually-calibrated for each participant via laboratory alcohol-administration. Over the next seven days, participants wore this transdermal alcohol monitor and responded to random survey prompts (6x/day), during which they provided photographs of their surroundings. Participants then reported on their levels of social familiarity with individuals visible in photographs. Multilevel models indicated a significant interaction between social anxiety and social familiarity in predicting drinking, b = -0.004, p =.003 Specifically, among participants higher in social anxiety, drinking increased as social familiarity decreased b = -0.152, p <.001, whereas among those lower in social anxiety, this relationship was non-significant, b = 0.007, p =.867. Considered alongside prior research, findings suggest that the presence of strangers within a given environment may play a role in the drinking behavior of socially anxious individuals.
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Affiliation(s)
- Eddie P Caumiant
- University of Illinois at Urbana-Champaign, Department of Psychology, United States.
| | - Catharine E Fairbairn
- University of Illinois at Urbana-Champaign, Department of Psychology, United States.
| | - Konrad Bresin
- University of Louisville, Department of Counseling and Human Development, United States; University of Louisville, Department of Psychological and Brain Sciences, United States
| | - I Gary Rosen
- University of Southern California, Department of Mathematics, United States
| | - Susan E Luczak
- University of Southern California, Department of Psychology, United States
| | - Dahyeon Kang
- University of Illinois at Urbana-Champaign, Department of Psychology, United States
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Miloslavich K, Leonard SJ, Wardle MC, Vujanovic AA. Alcohol Use Severity, Anger and Drinking Motives among Firefighters. Subst Use Misuse 2023; 58:601-609. [PMID: 36803652 DOI: 10.1080/10826084.2023.2177113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background: Firefighters represent an understudied population with high rates of hazardous alcohol use and alcohol use disorder. This population is also at an increased risk of mental health disorders and related symptoms such as anger. Anger is a relatively understudied negative mood state with clinical relevance to alcohol use among firefighters. Anger is associated with greater alcohol use and may spur more approach-motivated reasons for drinking compared to other negative emotions. Objectives: This study sought to examine: 1. whether anger significantly contributes to alcohol use severity in firefighters above and beyond general negative mood; 2. which of four validated drinking motives (e.g., coping, social, enhancement and conformity) act as moderators in the relationship between anger and alcohol use severity in this population. The current study is a secondary analysis of data from a larger study examining health and stress behaviors among firefighters (N = 679) at a large urban fire department in the southern United States. Results: Results revealed that anger was positively associated with alcohol use severity, even after controlling for general negative mood. Further, social and enhancement motives for drinking were significant moderators of the relationship between anger and alcohol use severity. Conclusions: These findings identify anger specifically as an important factor to be considered when assessing alcohol use in firefighters, especially those who are drinking to make social experiences more enjoyable or to enhance their mood. These findings can be used to inform more specialized interventions for alcohol use by targeting anger more specifically in firefighters and other male-dominated first-responder populations.
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Affiliation(s)
- Krista Miloslavich
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Samuel J Leonard
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Margaret C Wardle
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
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Goodman FR, Brown BA, Silva GM, Bradford DE, Tennen H, Kashdan TB. Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study. Behav Ther 2022; 53:600-613. [PMID: 35697425 DOI: 10.1016/j.beth.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 11/02/2022]
Abstract
People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences-namely positive social experiences-that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.
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Blumenthal H, Cloutier RM, Douglas ME, Kearns NT, Carey CN. Desire to drink as a function of laboratory-induced social stress among adolescents. J Behav Ther Exp Psychiatry 2021; 70:101617. [PMID: 32980586 PMCID: PMC8628538 DOI: 10.1016/j.jbtep.2020.101617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 09/13/2020] [Accepted: 09/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Research consistently demonstrates a link between social anxiety and alcohol-related problems; however, the majority of work has been retrospective, and conducted with adults. Despite an extensive literature highlighting coping-related motives as an underlying mechanism, real-time work presents mixed findings, and no published research has examined an adolescent sample using experimental psychopathology techniques. METHODS The current study tested whether (1) history of social anxiety symptoms positively correlated with alcohol-related cognitions following laboratory-induced social stress, (2) state anxiety was positively correlated with alcohol-related cognitions, and (3) whether the nature of the stressor (performance versus rejection) impacted the strength of identified relations, in a sample of community-recruited adolescents reporting recent alcohol use. Participants (n = 114; Mage = 16.01; 64% girls) were randomly assigned to either a performance- or rejection-oriented task. RESULTS Findings indicated that history of social anxiety symptoms was positively correlated with state anxiety elicited by both tasks. Further, history of social anxiety symptoms was not related to change in desire to drink, but was positively related to the belief that alcohol 'would make me feel better.' State anxiety was positively related to both desire to drink and relief outcome expectancies across both tasks. Finally, the nature of the task did not moderate responding. LIMITATIONS Single site, community sampling confines interpretations, and the tasks did not fully perform as expected. CONCLUSIONS Further study is needed; however, the current findings support the contention that socially-oriented distress may be a developmentally-relevant, malleable target for prevention efforts aimed at problematic alcohol use among adolescents.
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Affiliation(s)
- Heidemarie Blumenthal
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, United States.
| | - Renee M Cloutier
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, United States.
| | - Megan E Douglas
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, United States.
| | - Nathan T Kearns
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, United States.
| | - Caitlyn N Carey
- Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, United States.
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Stapinski LA, Sannibale C, Subotic M, Rapee RM, Teesson M, Haber PS, Baillie AJ. Randomised controlled trial of integrated cognitive behavioural treatment and motivational enhancement for comorbid social anxiety and alcohol use disorders. Aust N Z J Psychiatry 2021; 55:207-220. [PMID: 32900220 DOI: 10.1177/0004867420952539] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Alcohol use disorder and social anxiety disorder are interconnected disorders that commonly co-occur. We report the first trial to assess whether integrated treatment for social anxiety and alcohol use disorder comorbidity improves outcomes relative to standard alcohol-focussed treatment. METHOD Participants were recruited to a randomised controlled trial, and randomly allocated to one of two treatments, Integrated (n = 61) or Control (alcohol-focussed; n = 56). Assessment and treatment session were conducted at two sites in Sydney, Australia. Inclusion criteria were as follows: (1) clinical diagnosis of social anxiety disorder and (2) Diagnosis or sub-clinical symptoms of alcohol use disorder. Diagnoses were determined according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). All participants (n = 117) received 10 sessions of cognitive behavioural treatment and motivational enhancement. The Integrated treatment simultaneously targeted social anxiety disorder, alcohol use disorder and the connections between these disorders. The Control treatment focussed on alcohol use disorder only. Outcomes were assessed at 6-month follow-up, with interim assessments at post-treatment and 3 months. Primary outcomes were social anxiety disorder severity (composite Social Phobia Scale and Social Interaction Anxiety Scale), alcohol use disorder severity (standard drinks per day and Severity of Alcohol Dependence Questionnaire) and quality of life (Short-Form Health survey) was assessed to capture the combined impairment of social anxiety and alcohol use disorder comorbidity. RESULTS At 6-month follow-up, both conditions showed significant reductions in social anxiety and alcohol use disorder symptoms, and improved quality of life. There was no evidence of between-condition differences for alcohol outcomes, with mean consumption reduced by 5.0 (0.8) and 5.8 (1.0) drinks per day following Alcohol and Integrated treatments, respectively. Integrated treatment achieved greater improvements in social anxiety symptoms (mean difference = -14.9, 95% confidence interval = [-28.1, -1.6], d = 0.60) and quality of life (mean difference = 7.6, 95% confidence interval = [1.2, 14.0], d = 0.80) relative to alcohol-focused treatment. CONCLUSION These results suggest that integrated social anxiety and alcohol use disorder treatment enhances quality of life and social anxiety disorder symptom improvement, but not alcohol outcomes, compared to treatment focussed on alcohol use disorder alone.
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Affiliation(s)
- Lexine A Stapinski
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.,The Matilda Centre of Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia
| | - Claudia Sannibale
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Mirjana Subotic
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre of Research in Mental Health and Substance Use, The University of Sydney, Camperdown, NSW, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Paul S Haber
- Discipline of Addiction Medicine, The University of Sydney, Camperdown, NSW, Australia
| | - Andrew J Baillie
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
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Kummerfeld E, Rix A, Anker JJ, Kushner MG. Assessing the collective utility of multiple analyses on clinical alcohol use disorder data. J Am Med Inform Assoc 2019; 26:1046-1055. [PMID: 30990526 DOI: 10.1093/jamia/ocz034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/14/2019] [Accepted: 03/14/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the potential of combining graph learning methods with latent variable estimation methods for mining clinically useful information from observational clinical data sets. MATERIALS AND METHODS The data set contained self-reported measures of psychopathology symptoms from a clinical sample receiving treatment for alcohol use disorder. We used the traditional graph learning methods: Graphical Least Absolute Shrinkage and Selection Operator, and Friedman's hill climbing algorithm; traditional latent variable estimation method factor analysis; recently developed graph learning method Greedy Fast Causal Inference; and recently developed latent variable estimation method Find One Factor Clusters. Methods were assessed qualitatively by the content of their findings. RESULTS Recently developed graphical methods identified potential latent variables (ie, not represented in the model) influencing particular scores. Recently developed latent effect estimation methods identified plausible cross-score loadings that were not found with factor analysis. A graphical analysis of individual items identified a mistake in wording on 1 questionnaire and provided further evidence that certain scores are not reflective of indirectly measured common causes. DISCUSSION AND CONCLUSION Our findings suggest that a combination of Greedy Fast Causal Inference and Find One Factor Clusters can enhance the evidence-based information yield from psychopathological constructs and questionnaires. Traditional methods provided some of the same information but missed other important findings. These conclusions point the way toward more informative interrogations of existing and future data sets than are commonly employed at present.
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Affiliation(s)
- Erich Kummerfeld
- University of Minnesota - Institute for Health Informatics, Minneapolis, Minnesota, USA
| | - Alexander Rix
- University of Minnesota - Institute for Health Informatics, Minneapolis, Minnesota, USA
| | - Justin J Anker
- University of Minnesota - Department of Psychiatry, Minneapolis, Minnesota, USA
| | - Matt G Kushner
- University of Minnesota - Department of Psychiatry, Minneapolis, Minnesota, USA
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Collins JL, Sherry SB, McKee K, Thompson K, Stewart SH. Do Drinking Motives and Drinking Contexts Mediate the Relationship Between Social Avoidance and Alcohol Problems? Evidence from Two Studies of Undergraduate Drinkers. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00092-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Goodman FR, Stiksma MC, Kashdan TB. Social Anxiety and the Quality of Everyday Social Interactions: The Moderating Influence of Alcohol Consumption. Behav Ther 2018; 49:373-387. [PMID: 29704967 DOI: 10.1016/j.beth.2017.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 02/02/2023]
Abstract
Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions. Participants (N = 160) completed demographic and trait measures, then completed daily assessments for 14 consecutive days. Results from multilevel model analyses revealed that during face-to-face social interactions, state social anxiety was inversely related to 10 indicators of healthy social interactions (e.g., enjoyment, laughter, feelings of acceptance). Alcohol consumption moderated seven of these associations, such that when participants consumed alcohol in social situations, state social anxiety was no longer associated with social interaction quality. The quantity of alcoholic drinks consumed moderated two of these associations. Furthermore, we found evidence for directionality, such that social anxiety in a given social interaction predicted alcohol consumption in a subsequent social interaction, but not the reverse (i.e., alcohol consumption did not prospectively predict state social anxiety). In social situations that involved alcohol, experiences of social anxiety no longer thwarted one's ability to derive social benefits. These results should be interpreted in the context of a participant sample with relatively low levels of trait social anxiety and frequency of alcohol use. Nonetheless, obtaining social rewards may be a reinforcement mechanism that maintains the link between social anxiety and alcohol consumption.
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Rambau S, Forstner AJ, Wegener I, Mücke M, Wissussek CTS, Staufenbiel SM, Geiser F, Schumacher J, Conrad R. Childhood adversities, bonding, and personality in social anxiety disorder with alcohol use disorder. Psychiatry Res 2018; 262:295-302. [PMID: 29477673 DOI: 10.1016/j.psychres.2018.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 01/30/2018] [Accepted: 02/02/2018] [Indexed: 10/18/2022]
Abstract
Social anxiety disorder (SAD) is frequently associated with alcohol use disorders (abuse/dependence). However, there has been little research on the characteristics of this subgroup so far. In the current study we investigated individuals with SAD and comorbid alcohol use disorder (AUD) with regard to socialization experiences and personality. The sample comprised 410 individuals diagnosed with SAD by the Structured Clinical Interview of DSM-IV. 108 participants with comorbid AUD were compared to 302 participants without comorbid AUD concerning traumatic experiences during childhood and adolescence (Adverse Childhood Experiences Questionnaire; ACE), parental bonding (Parental Bonding Instrument; PBI), and personality (Temperament and Character Inventory; TCI). MANCOVA with covariates sex and depression displayed that individuals with SAD plus AUD reported significantly more traumatic events during childhood and adolescence, lower levels of maternal care, as well as lower cooperativeness. Our results highlight that adverse childhood experiences and unfavourable maternal bonding characterize individuals suffering from SAD plus AUD. These experiences might be reflected in a personality-based tendency to distance themselves from others, which corresponds to low scores on the character dimension cooperativeness. A deeper understanding of personality and specific socialization experiences is necessary to develop new treatment options in this clinically challenging subgroup.
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Affiliation(s)
- Stefanie Rambau
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany; Department of Psychiatry (UPK), University of Basel, Basel, Switzerland; Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland.
| | - Ingo Wegener
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Martin Mücke
- Department of Palliative Medicine, University of Bonn, Bonn, Germany.
| | | | - Sabine M Staufenbiel
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
| | - Johannes Schumacher
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.
| | - Rupert Conrad
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
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Ertl V, Preuße M, Neuner F. Are Drinking Motives Universal? Characteristics of Motive Types in Alcohol-Dependent Men from Two Diverse Populations. Front Psychiatry 2018; 9:38. [PMID: 29487544 PMCID: PMC5816937 DOI: 10.3389/fpsyt.2018.00038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/29/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND AIMS Since alcohol use disorders are among the most prevalent and destructive mental disorders, it is critical to address factors contributing to their development and maintenance. Drinking motives are relevant driving factors for consumption. Identifying groups of drinkers with similar motivations may help to specialize intervention components and make treatment more effective and efficient. We aimed to identify and describe distinct motive types of drinkers in dependent males from two diverse cultures (Uganda and Germany) and to explore potential differences and similarities in addiction-related measures. Moreover, we investigated specific links between motive types and childhood maltreatment, traumatic experiences, and symptoms of comorbid psychopathologies. METHODS To determine distinct drinking motive types, we conducted latent class analyses concerning drinking motives (Drinking Motive Scale) in samples of treatment-seeking alcohol-dependent men (N = 75). Subsequently we compared the identified motive types concerning their alcohol consumption and alcohol-related symptoms (Alcohol Use Disorders Identification Test), history of childhood maltreatment (Childhood Trauma Questionnaire), trauma exposure (Violence, War and Abduction Exposure Scale), psychopathology (Posttraumatic Stress Diagnostic Scale, Depression-section of the Hopkins Symptom Checklist, and Brief Symptom Inventory) and deficits in emotion regulation (Difficulties in Emotion Regulation Scale). RESULTS We found two congruent drinking motive types in both contexts. Reward-oriented drinking motives like the generation of positive feelings and enhancing performance were endorsed almost equally by both motive types, whereas high relief motive endorsement characterized one group, but not the other. The relief motive type drank to overcome aversive feelings, withdrawal, and daily hassles and was characterized by higher adversity in general. Emotional maltreatment in childhood and psychopathological symptoms were reported to a significantly greater extent by relief drinkers (effect sizes of comparisons ranging from r = 0.25 to r = 0.48). However, the motive types did not differ significantly on alcohol consumption or alcohol-related symptoms and traumatic experiences apart from childhood maltreatment. CONCLUSION The chronology of addiction development and patterns of drinking motivation seem to be similar across cultures, i.e., that motive targeting interventions might be applicable cross-culturally. Addressing comorbid symptomatology should be a key treatment component for relief drinkers, whereas finding alternatives for the creation of positive feelings and ways to counteract boredom and inactivity should be a general treatment element.
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Affiliation(s)
- Verena Ertl
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Melissa Preuße
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
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12
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Internet Gaming Disorder Behaviors in Emergent Adulthood: a Pilot Study Examining the Interplay Between Anxiety and Family Cohesion. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-9873-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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13
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Collins JL, Thompson K, Sherry SB, Glowacka M, Stewart SH. Drinking to cope with depression mediates the relationship between social avoidance and alcohol problems: A 3-wave, 18-month longitudinal study. Addict Behav 2018; 76:182-187. [PMID: 28846938 DOI: 10.1016/j.addbeh.2017.08.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/21/2017] [Accepted: 08/17/2017] [Indexed: 11/28/2022]
Abstract
Undergraduates with high social anxiety have increased alcohol problems, despite lower or equivalent alcohol use levels. Drinking motives mediate the cross-sectional relationship between social anxiety and alcohol problems, with coping and conformity motives being the most commonly observed mediators. Our study extended prior research by using a longitudinal design, examining coping with anxiety motives (CAM) and coping with depression motives (CDM) separately using path analysis, simultaneously considering a variety of drinking motives in the model, and focusing on a particularly severe form of social anxiety - namely, social avoidance. We collected data from 219 undergraduates (72.6% women, mean age of 20.59years) over three waves spaced six months apart. Results indicated CDM mediated the prospective relationship between social avoidance and alcohol problems. Findings suggest socially avoidant students' escalations in CDM explain their increased alcohol problems over time. Future research should examine involvement of depression and social isolation in contributing to this pathway to alcohol problems.
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Affiliation(s)
- Jamie-Lee Collins
- Dalhousie University, Department of Psychology and Neuroscience, 1355 Oxford Street, PO Box 15000, Halifax, Nova Scotia B3H 4R2, Canada.
| | - Kara Thompson
- Saint Francis Xavier University(,) Psychology Department(,) Annex, 125, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Simon B Sherry
- Dalhousie University, Department of Psychology and Neuroscience, 1355 Oxford Street, PO Box 15000, Halifax, Nova Scotia B3H 4R2, Canada
| | - Maria Glowacka
- Dalhousie University, Department of Psychology and Neuroscience, 1355 Oxford Street, PO Box 15000, Halifax, Nova Scotia B3H 4R2, Canada
| | - Sherry H Stewart
- Dalhousie University, Department of Psychiatry, 5909 Veteran's Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada; Dalhousie University, Department of Psychology and Neuroscience, 1355 Oxford Street, PO Box 15000, Halifax, Nova Scotia B3H 4R2, Canada
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Breet E, Bantjes J. Substance Use and Self-Harm: Case Studies From Patients Admitted to an Urban Hospital Following Medically Serious Self-Harm. QUALITATIVE HEALTH RESEARCH 2017; 27:2201-2210. [PMID: 28891407 DOI: 10.1177/1049732317728052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Few qualitative studies have explored the relationship between substance use and self-harm. We employed a multiple-case study research design to analyze data from 80 patients who were admitted to a hospital in South Africa following self-harm. Our analysis revealed, from the perspective of patients, a number of distinct ways in which substance use is implicated in self-harm. Some patients reported that substance intoxication resulted in poor decision making and impulsivity, which led to self-harm. Others said substance use facilitated their self-harm. Some participants detailed how in the past their chronic substance use had served an adaptive function helping them to cope with distress, but more recently, this coping mechanism had failed which precipitated their self-harm. Some participants reported that substance use by someone else triggered their self-harm. Findings suggest that there are multiple pathways and a host of variables which mediate the relationship between substance use and self-harm.
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Affiliation(s)
- Elsie Breet
- 1 Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- 1 Stellenbosch University, Stellenbosch, South Africa
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Stavropoulos V, Gomez R, Steen E, Beard C, Liew L, Griffiths MD. The longitudinal association between anxiety and Internet addiction in adolescence: The moderating effect of classroom extraversion. J Behav Addict 2017; 6:237-247. [PMID: 28517956 PMCID: PMC5520123 DOI: 10.1556/2006.6.2017.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and aims The risk effect of anxiety on addictive behaviors, including Internet addiction (IA), has repeatedly been highlighted in the international literature. However, there is a lack of longitudinal studies examining this association in relation to proximal context effects, particularly in adolescence. Such findings would shed light on potential age- and proximal context-related variations in the anxiety-IA association that could better inform IA prevention and intervention initiatives. Methods In this study, 648 adolescents, embedded in 34 classrooms, were assessed at the age of 16 and again at the age of 18 to examine the effect of anxiety on IA behaviors in relation to the average level of classroom extraversion. IA was assessed with the Internet Addiction Test (Young, 1998), anxiety with the relevant subscale of the Symptom Checklist 90 - Revised (Derogatis & Savitz, 1999) and classroom extraversion with the synonymous subscale of the Five Factor Questionnaire (Asendorpf & van Aken, 2003). A three-level hierarchical linear model was calculated. Results The present findings demonstrated that: (a) higher levels of anxiety were significantly associated with higher IA behaviors, (b) the strength of this association did not vary over time (between 16 and 18 years old), and (c) however, it tended to weaken within classrooms higher in extraversion. Discussion This study indicated that the contribution of individual IA risk factors might differently unfold within different contexts.
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Affiliation(s)
- Vasileios Stavropoulos
- Department of Psychology, University of Athens, Athens, Greece,Department of Psychology, Federation University Australia, Ballarat, VIC, Australia,Corresponding author: Vasileios Stavropoulos; School of Health Sciences and Psychology, Faculty of Health, Federation University Australia, Office H206, Building H, Mt Helen Campus, PO Box 663, Ballarat, VIC 3353, Australia; Phone: +61 0450903687; Fax: +61 353279018; E-mail:
| | - Rapson Gomez
- Department of Psychology, Federation University Australia, Ballarat, VIC, Australia
| | - Eloisa Steen
- Department of Psychology, Flinders University, Adelaide, SA, Australia
| | - Charlotte Beard
- Department of Psychology, Palo Alto University, Palo Alto, CA, USA
| | - Lucas Liew
- Department of Psychology, Federation University Australia, Ballarat, VIC, Australia
| | - Mark D. Griffiths
- International Gaming Unit, Psychology Division, Nottingham Trent University, Nottingham, UK
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Anker JJ, Forbes MK, Almquist ZW, Menk JS, Thuras P, Unruh AS, Kushner MG. A network approach to modeling comorbid internalizing and alcohol use disorders. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:325-339. [PMID: 28182444 PMCID: PMC5388354 DOI: 10.1037/abn0000257] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Internalizing disorders co-occur with alcohol use disorder (AUD) at a rate that exceeds chance and compromise conventional AUD treatment. The "vicious cycle" model of comorbidity specifies drinking to cope (DTC) as a link between these disorders that, when not directly addressed, undermines the effectiveness of conventional treatments. Interventions based on this model have proven successful but there is no direct evidence for how and to what extent DTC contributes to the maintenance of comorbidity. In the present study, we used network analysis to depict associations between syndrome-specific groupings of internalizing symptoms, alcohol craving, and drinking behavior, as well as DTC and other extradiagnostic variables specified in the vicious cycle model (e.g., perceived stress and coping self-efficacy). Network analyses of 362 individuals with comorbid anxiety and AUD assessed at the beginning of residential AUD treatment indicated that while internalizing conditions and drinking elements had only weak direct associations, they were strongly connected with DTC and perceived stress. Consistent with this, centrality indices showed that DTC ranked as the most central/important element in the network in terms of its "connectedness" to all other network elements. A series of model simulations-in which individual elements were statistically controlled for-demonstrated that DTC accounted for all the relationships between the drinking-related elements and internalizing elements in the network; no other variable had this effect. Taken together, our findings suggest that DTC may serve as a "keystone" process in maintaining comorbidity between internalizing disorders and AUD. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Jeremiah S Menk
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute
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17
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Peterlik D, Flor PJ, Uschold-Schmidt N. The Emerging Role of Metabotropic Glutamate Receptors in the Pathophysiology of Chronic Stress-Related Disorders. Curr Neuropharmacol 2016; 14:514-39. [PMID: 27296643 PMCID: PMC4983752 DOI: 10.2174/1570159x13666150515234920] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 04/04/2015] [Accepted: 05/12/2015] [Indexed: 12/28/2022] Open
Abstract
Chronic stress-related psychiatric conditions such as anxiety, depression, and alcohol abuse are an enormous public health concern. The etiology of these pathologies is complex, with psychosocial stressors being among the most frequently discussed risk factors. The brain glutamatergic neurotransmitter system has often been found involved in behaviors and pathophysiologies resulting from acute stress and fear. Despite this, relatively little is known about the role of glutamatergic system components in chronic psychosocial stress, neither in rodents nor in humans. Recently, drug discovery efforts at the metabotropic receptor subtypes of the glutamatergic system (mGlu1-8 receptors) led to the identification of pharmacological tools with emerging potential in psychiatric conditions. But again, the contribution of individual mGlu subtypes to the manifestation of physiological, molecular, and behavioral consequences of chronic psychosocial stress remains still largely unaddressed. The current review will describe animal models typically used to analyze acute and particularly chronic stress conditions, including models of psychosocial stress, and there we will discuss the emerging roles for mGlu receptor subtypes. Indeed, accumulating evidence indicates relevance and potential therapeutic usefulness of mGlu2/3 ligands and mGlu5 receptor antagonists in chronic stress-related disorders. In addition, a role for further mechanisms, e.g. mGlu7-selective compounds, is beginning to emerge. These mechanisms are important to be analyzed in chronic psychosocial stress paradigms, e.g. in the chronic subordinate colony housing (CSC) model. We summarize the early results and discuss necessary future investigations, especially for mGlu5 and mGlu7 receptor blockers, which might serve to suggest improved therapeutic strategies to treat stress-related disorders.
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Affiliation(s)
| | - Peter J Flor
- Faculty of Biology and Preclinical Medicine, University of Regensburg, D-93053 Regensburg, Germany.
| | - Nicole Uschold-Schmidt
- Faculty of Biology and Preclinical Medicine, University of Regensburg, D-93053 Regensburg, Germany.
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18
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Fragoso YD, Gomes S, Goncalves MVM, Machado SCN, Morales RDR, Oliveira FTMD, Oliveira JFD, Olmo NRS, Parolin MKF, Siquineli F, Stoney PN. Patients with multiple sclerosis do not necessarily consume more alcohol or tobacco than the general population. ARQUIVOS DE NEURO-PSIQUIATRIA 2015; 73:828-33. [DOI: 10.1590/0004-282x20150117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 06/01/2015] [Indexed: 11/22/2022]
Abstract
Purpose Recent papers suggest that patients with multiple sclerosis (MS) are prone to alcohol misuse. This may be due to the combination of a lifelong and disabling disease with a psychiatric profile typical of MS. The objective of the present study was to assess these findings in a culturally different population of patients with MS.Method The present case-control transversal study assessed 168 patients with MS and 168 control subjects from Brazil.Results There were no evidence that patients with MS drank more alcohol or, smoked more than did controls. In fact, control subjects had a significantly higher alcohol consumption. The only trait associated to higher alcohol consumption was anxiety, both for patients and controls.Conclusion Unlike previous reports in the literature, patients with MS in our study did not drink or smoked more than a control population.
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Affiliation(s)
| | - Sidney Gomes
- Hospital Beneficencia Portuguesa, Brazil; Hospital Paulistano, Brazil
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Battista SR, MacKinnon SP, Sherry SB, Barrett SP, MacNevin PD, Stewart SH. Does Alcohol Reduce Social Anxiety in Daily Life? A 22-Day Experience Sampling Study. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2015. [DOI: 10.1521/jscp.2015.34.6.508] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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20
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Cox WM, Klinger E, Fadardi JS. The motivational basis of cognitive determinants of addictive behaviors. Addict Behav 2015; 44:16-22. [PMID: 25499579 DOI: 10.1016/j.addbeh.2014.11.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 11/12/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
If a person expects that (a) drinking alcohol or using another addictive substance will enhance positive affect or reduce negative affect, and (b) there is a strong likelihood that these desirable consequences will occur if the substance is used, that person is likely to form a goal of using the substance. The theoretical framework presented here predicts that when that happens, the person will have a current concern for using the substance, with the person thereby sensitized to environmental stimuli related to procuring and using the substance. One indication of the sensitization is selective attention to substance-related stimuli, which is correlated with urges to use and actual use of the substance. Accordingly, interventions have been developed for helping substance users to overcome substance-related attentional bias. The results are promising for reducing both the attentional bias and the substance use. Finally, we discuss other cognitive-modification and motivational techniques that have been evaluated with promising results.
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New-Onset Substance Use Disorder After Gastric Bypass Surgery: Rates and Associated Characteristics. Obes Surg 2014; 24:1975-80. [DOI: 10.1007/s11695-014-1317-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Weiss RD, Potter JS, Griffin ML, McHugh RK, Haller D, Jacobs P, Gardin J, Fischer D, Rosen KD. Reasons for opioid use among patients with dependence on prescription opioids: the role of chronic pain. J Subst Abuse Treat 2014; 47:140-5. [PMID: 24814051 DOI: 10.1016/j.jsat.2014.03.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 02/07/2014] [Accepted: 03/24/2014] [Indexed: 11/19/2022]
Abstract
The number of individuals seeking treatment for prescription opioid dependence has increased dramatically, fostering a need for research on this population. The aim of this study was to examine reasons for prescription opioid use among 653 participants with and without chronic pain, enrolled in the Prescription Opioid Addiction Treatment Study, a randomized controlled trial of treatment for prescription opioid dependence. Participants identified initial and current reasons for opioid use. Participants with chronic pain were more likely to report pain as their primary initial reason for use; avoiding withdrawal was rated as the most important reason for current use in both groups. Participants with chronic pain rated using opioids to cope with physical pain as more important, and using opioids in response to social interactions and craving as less important, than those without chronic pain. Results highlight the importance of physical pain as a reason for opioid use among patients with chronic pain.
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Affiliation(s)
- Roger D Weiss
- McLean Hospital, 115 Mill St, Belmont, MA 02478, United States; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States.
| | - Jennifer Sharpe Potter
- McLean Hospital, 115 Mill St, Belmont, MA 02478, United States; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States; University of Texas Health Science Center San Antonio, 7526 Louis Pasteur MC7733, San Antonio, TX, 78229, United States
| | - Margaret L Griffin
- McLean Hospital, 115 Mill St, Belmont, MA 02478, United States; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States
| | - R Kathryn McHugh
- McLean Hospital, 115 Mill St, Belmont, MA 02478, United States; Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, United States
| | - Deborah Haller
- Behavioral Science Research Unit, Mt. Sinai at St. Luke's, 1111 Amsterdam Ave., New York, NY, 10025, United States
| | - Petra Jacobs
- Universidad San Francisco de Quinto, Escuela De Medicina, Quito, Ecuador
| | - John Gardin
- Adapt, Inc., 548 SE Jackson St., Roseburg, OR 97470, United States
| | - Dan Fischer
- University of New Mexico Center on Alcoholism, Substance Abuse, and Addictions (CASAA), 2650 Yale SE MSC11-6280 Albuquerque, NM 87106, United States
| | - Kristen D Rosen
- University of Texas Health Science Center San Antonio, 7526 Louis Pasteur MC7733, San Antonio, TX, 78229, United States
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