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McDonagh D, de Vries J, Cominskey C. The Role of Adverse Childhood Experiences on People in Opiate Agonist Treatment: The Importance of Feeling Unloved. Eur Addict Res 2023; 29:313-322. [PMID: 37669628 DOI: 10.1159/000532005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/06/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION Adults in opiate agonist treatment (OAT) often have a background of adverse childhood experiences (ACEs) and are more likely to be exposed to a variety of risks that may trigger post-traumatic stress disorder (PTSD). Summative ACE scores are often used to identify individuals at risk of PTSD and continued substance use. What has not been addressed is whether specific ACE factors are exerting a greater influence on the individual. This study investigated whether specific ACEs predicted PTSD, and current continued substance use among adults in long-term OAT. METHODS An analysis of data that were collected at the follow-up stage of a study among 131 adults who attended OAT was conducted. Participants attended one of six OAT settings, covering 45% (n = 890) of clients in a defined area of Dublin, Ireland in 2017. Interviews were conducted with 104 participants, 66 males (63%) and 38 females (37%), with an average age of 43 years (SD = 7.4). The Adverse Childhood Questionnaire (ACQ); PTSD checklist (PCL-5); heroin; tranquilliser; cannabis; alcohol; and cocaine used in the previous 28 days were measured using the quantity used score within the Opiate Treatment Index. Socio-demographics and age of first use of these four substances were also collected. The analysis has focussed on relating ACEs to PTSD, age of first drugs use, and current drug use of the participants. RESULTS Bivariate analysis showed that the summative ACQ score was significantly correlated with age of first opiate use (p = 0.004). Multiple regression analysis showed that the summative ACQ score and tranquilliser use predicted higher levels of PTSD (R2 = 0.50). Four specific ACEs predicted 54% of the variance in PTSD, these were feeling unloved (β = 0.328) living with a household member who had a problem with alcohol or used illicit street drugs (β = 0.280); verbal abuse (β = 0.219); and living with a person who had a mental illness (β = 0.197). CONCLUSIONS While a summation of all ten ACEs predicted higher levels of PTSD, the factor "feeling unloved" as a child provided the single strongest predictor and may represent an overarching risk of PTSD and continued substance use in later life among adults in treatment for an opiate use disorder.
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Affiliation(s)
- David McDonagh
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Jan de Vries
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Unterrainer HF. On the trail of Sisyphus - addiction as an existential neurosis? Front Psychiatry 2023; 14:1243792. [PMID: 37692306 PMCID: PMC10483396 DOI: 10.3389/fpsyt.2023.1243792] [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: 06/21/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
In Greek mythology, Sisyphus, king of the Corinthians, dared to deceive the gods and was condemned to roll a boulder to the top of a mountain for all eternity. Shortly before reaching the summit, however, the boulder rolled back down into the valley, and the arduous task had to begin anew. Many of the contents of this classic myth are reminiscent of the therapeutic approach to addictive disorders. In addiction therapy, too, it is often a long and rocky road that ends with a relapse. The therapeutic effort was not entirely in vain, but one often begins to doubt its usefulness. In terms of Sisyphus and a Bio-Psycho-Social Model (BPSM) of health and disease, addiction can be located at the end of a downward spiral. By extension of the BPSM, can addictive disease be considered an expression of existential neurosis? The results of our own research speak in favor of this and show a clearly reduced experience of sense and meaning, but also diminished feelings of hope and forgiveness in addiction patients. However, positive correlations between various parameters of existential well-being and mental health or more appropriate stress coping are also found for the addiction group. These results are supported by neuronal correlates and are mirrored in the general population. Based on this, the consideration of existential issues in addiction therapy can be discussed. Finally, the use of art therapy and work training are proposed as examples of a meaning based therapeutic intervention in dealing with people with addictive diseases.
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Affiliation(s)
- Human-Friedrich Unterrainer
- Faculty of Psychotherapy Science, Sigmund Freud University, Vienna, Austria
- Center for Integrative Addiction Research (CIAR), Grüner Kreis Association, Vienna, Austria
- Institute for Religious Studies, University of Vienna, Vienna, Austria
- University Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
- Institute of Psychology, University of Graz, Graz, Austria
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3
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Ghinassi S, Casale S. The Role of Attachment in Gambling Behaviors and Gambling Disorder: A Systematic Review. J Gambl Stud 2023; 39:713-749. [PMID: 36322300 PMCID: PMC10175436 DOI: 10.1007/s10899-022-10163-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2022] [Indexed: 05/13/2023]
Abstract
In recent years, a growing number of attachment-based studies have contributed to the understanding of both substance and behavioral addictions. Although gambling is a form of addictive behavior widespread all over the world, both among young people and adults, the evidence on the association between attachment-related phenomena and gambling has not yet been systematized in literature. The aim of the present study, therefore, is to provide a systematic literature review aimed at summarizing the empirical evidence on this topic. Following the updated 2020 PRISMA guidelines, a systematic search in four electronic scientific databases (Scopus, PubMed, PsycInfo and Web of Science) was conducted. After removing duplicates, 146 records were double-screened, with 12 articles meeting the inclusion criteria. Additionally, by means of a backward search a further article was selected. Altogether, 13 articles were selected for the present systematic review. With few exceptions, the results underline the significant role played by attachment-related phenomena in gambling behaviors, highlighting that specific attachment contexts have a different influence on gambling, also depending on whether gamblers are youths or adults. In particular, while secure attachment has proven to be a protective factor for the onset of gambling behavior, insecure attachment has emerged to be a vulnerability factor in two ways. On the one hand, it directly favors gambling behaviors; on the other, it affects coping strategies and the individual's ability to identify and regulate emotions, which in turn predict gambling. Limitations, strengths, and implications of the present systematic review are discussed.
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Affiliation(s)
- Simon Ghinassi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, 50134, Florence, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Via di San Salvi, 12, 50135, Florence, Italy.
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4
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Kim EM, Kim H. Multilevel Factors Associated With Lifetime, Current, and Binge Drinking Among Korean Adolescents Based on the Ecological Model. J Addict Nurs 2023; 34:135-145. [PMID: 37276203 DOI: 10.1097/jan.0000000000000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Drinking usually begins in adolescence and is a major public health concern. Few studies have identified multilevel factors considering the frequency and amount of drinking among adolescents. This study aimed to identify the multilevel factors associated with lifetime, current, and binge drinking among Korean adolescents based on the ecological model. METHODS This cross-sectional study used data from the 2018 Korea Youth Risk Behavior Survey (N = 60,040). Hierarchal multinomial logistic regression analyses were performed using complex sample data. RESULTS Overall, 15,030 (25.4%), 4,629 (8.0%), and 5,038 (8.9%) subjects were involved in lifetime, current, and binge drinking, respectively. The following multilevel factors revealed significant associations with lifetime, current, and binge drinking: boys, high school students, depression, suicidal ideation at individual level, family acceptance of alcohol use, poor household economic status at family level, poor academic achievement, not receiving education on alcohol use at school level, possible alcohol access, and harm caused by drinkers at social level (all ps < .01). The main risk factors were family acceptance of alcohol use (lifetime, current, and binge drinking vs. OR = 3.95, 6.88, and 5.46, respectively) and possible alcohol access (OR = 5.65, 19.78, and 93.62). DISCUSSION This study revealed multilevel factors associated with lifetime, current, and binge drinking. School nurses and community leaders are necessary to develop customized drinking prevention programs considering drinking frequency and amount, and individual, family, school, and social factors. Especially, the implementation of a drinking prevention program that reduces family acceptance of alcohol use and access to alcohol could be an effective strategy.
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Amini M, Abdolahpur MA, Bach B, Darharaj M, Hamraz I, Javaheri A, Lotfi M. The Relationship between Traumatic Life Events and Polysubstance Use: Examining the Mediating Role of DSM-5 Level of Personality Functioning and Maladaptive Personality Traits. THE JOURNAL OF PSYCHOLOGY 2023; 157:227-241. [PMID: 36919464 DOI: 10.1080/00223980.2023.2182265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The experience of traumatic events in childhood is an important risk factor for the initiation and continuation of polysubstance use. This study aimed to examine the mediating role of DSM-5 level of personality functioning and maladaptive personality traits in the relationship between traumatic life events and polysubstance use. We used a mixed sample (N = 290; Mage = 40; SDage = 12.26; 75.2% males) of patients with substance use disorder (SUD; including 90 mono-drug users and 113 polysubstance users) and non-users (including 87 university students) recruited using convenience sampling method from harm reduction-oriented drug treatment centers and universities respectively in Tehran, Iran. Participants completed the Level of Personality Functioning Scale-Brief Form, the Personality Inventory for DSM 5-Brief Form, and the Life Events Checklist-Revised. The results of structural equation modeling showed that DSM-5 level of personality functioning and maladaptive personality traits partially mediated the relationship between traumatic life events and polysubstance use. Experiencing traumatic events may contribute to the risk of polysubstance use through the effect of global personality dysfunction and specific personality traits. This proposed mediational model must be replicated using a longitudinal design across different populations.
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Affiliation(s)
| | | | - Bo Bach
- Center for Personality Disorder Research, Psychiatric Research Unit
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6
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Lawrence TI, Mcfield AA, Byrne MM, S.Tarver S, Stewart TK. Depression and Substance Use as Consequences of Exposure to Family Violence: A Moderation Mediation and Self-Medication Hypothesis Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:69-79. [PMID: 36776628 PMCID: PMC9908810 DOI: 10.1007/s40653-022-00464-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/18/2023]
Abstract
Ample evidence exists suggesting that exposure to family violence leads to substance use and this relationship is moderated by gender; however, much is still unknown of the underlying mechanism of this relationship. Thus, the current study first examined whether exposure to family violence was associated with substance use. Then consistent with the self-medication hypothesis, we tested whether depressive symptoms mediated the relations between exposure to family violence and substance use. Finally, we examined the moderating effect of gender on the relationships among exposure to family violence and depressive symptoms/substance use (N = 1,850). Results suggest that exposure to family violence positively associated with substance use. Mediation results revealed that depressive symptoms explained the relationship between exposure to family violence and substance use. Moderation results indicated that males who were exposed to family violence were more likely to endorse depressive symptoms and more likely to use substances while controlling for sibling aggression victimization. This study provides new insight into the internalizing and externalizing symptoms of exposure to family violence, specifically for male adolescents. Implications are discussed.
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Affiliation(s)
| | - Ariel A. Mcfield
- University of Texas Permian Basin, 4901 East University, Odessa, TX 79762 USA
| | - Madeleine M. Byrne
- Dallas County Juvenile Department, Psychology Division, 2600 Lone Star Rd. Dallas, Dallas, TX 75212 USA
| | - Sheree S.Tarver
- Dallas County Juvenile Department, Psychology Division, 10503 Denton Dr, Dallas, TX 75220 USA
| | - Tiah K. Stewart
- Prairie View A&M University, P. O Box 519 MS, Prairie View, TX 2699 USA
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7
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Emotional Dysregulation and Craving in Patients with Substance Use Disorder: the Mediating Role of Psychological Distress. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01031-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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8
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Gori A, Topino E, Cacioppo M, Craparo G, Schimmenti A, Caretti V. An Integrated Approach to Addictive Behaviors: A Study on Vulnerability and Maintenance Factors. Eur J Investig Health Psychol Educ 2023; 13:512-524. [PMID: 36975391 PMCID: PMC10047755 DOI: 10.3390/ejihpe13030039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial–parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.
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Affiliation(s)
- Alessio Gori
- Department of Health Sciences, University of Florence, Via di San Salvi 12, Pad. 26, 50135 Firenze, Italy
- Integrated Psychodynamic Psychotherapy Institute (IPPI), Via Ricasoli 32, 50122 Florence, Italy
- Correspondence:
| | - Eleonora Topino
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
| | - Marco Cacioppo
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
| | - Giuseppe Craparo
- Faculty of Human and Social Sciences, UKE—Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE—Kore University of Enna, Cittadella Universitaria, 94100 Enna, Italy
| | - Vincenzo Caretti
- Department of Human Sciences, LUMSA University of Rome, Via della Traspontina, 21, 00193 Rome, Italy
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9
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Rice M, Dean AC, Suh J, London ED. Denial and Diagnosis of Methamphetamine Dependence Severity. Subst Abuse 2022; 16:11782218221135721. [PMID: 36385745 PMCID: PMC9647299 DOI: 10.1177/11782218221135721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 09/12/2022] [Indexed: 06/04/2024]
Abstract
Introduction Denial, or lack of awareness of problems related to substance misuse, is a common feature of drug use disorders and can affect engagement in treatment and recovery. This study tested for association of denial with severity of symptoms used in the diagnosis of Methamphetamine Dependence. Methods This secondary analysis used data from 69 participants (52.2% male) who met criteria for the diagnosis of Methamphetamine Dependence on the Structured Clinical Interview for DSM-IV (SCID). The association between diagnostic severity, determined from a SCID summary score (8 items), and denial, measured by the University of Rhode Island Change Assessment Scale (URICA) Precontemplation score, was tested by Pearson correlation. In post hoc t-tests, participants who differed on individual SCID items were compared on the Precontemplation score. The additional URICA subscales (Contemplation, Maintenance, Action) were also tested on a secondary basis. Results SCID summary scores were negatively correlated with URICA Precontemplation scores (P = .003). Post-hoc tests revealed that participants who denied continued methamphetamine use despite persistent or recurrent problems (SCID item 6) had significantly higher Precontemplation scores than those who endorsed these problems (t = 3.066, P = .003). In contrast, positive correlations were observed between diagnostic severity and greater openness/willingness to change on the URICA (eg, Maintenance, r = .26; P = .01). Conclusions The findings highlight the importance of a patient's insight regarding their addiction in clinical diagnosis. Because minimizing the impact of methamphetamine use may preclude or delay treatment, it is advised that self-report be supplemented to improve accuracy of diagnosis.
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Affiliation(s)
- Myra Rice
- Neuroscience Interdepartmental Graduate
Program, University of California, Los Angeles, CA, USA
| | - Andy C Dean
- Department of Psychiatry and
Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA,
USA
- Brain Research Institute, University of
California, Los Angeles, Los Angeles, CA, USA
| | - Jaymee Suh
- Department of Psychiatry and
Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA,
USA
| | - Edythe D London
- Department of Psychiatry and
Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA,
USA
- Brain Research Institute, University of
California, Los Angeles, Los Angeles, CA, USA
- Department of Molecular and Medical
Pharmacology, David Geffen School of Medicine, University of California, Los
Angeles, Los Angeles, CA, USA
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10
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Buckner JD, Morris PE, Shepherd JM, Zvolensky MJ. Ethnic-racial identity and hazardous drinking among black drinkers: A test of the minority stress model. Addict Behav 2022; 127:107218. [PMID: 34959079 DOI: 10.1016/j.addbeh.2021.107218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/01/2022]
Abstract
Black Americans who consume alcohol experience negative alcohol-related outcomes, indicating a need to identify psycho-sociocultural factors that may play a role in drinking and related problems to inform prevention and treatment. Although lower levels of ethnic-racial identity (ERI) are related to negative drinking outcomes, this is the first known test of whether psychological distress and drinking to cope with distress play a role in these relations. Participants were 155 Black current drinking undergraduates at a racially/ethnically diverse university. ERI was significantly, negatively correlated with drinking frequency, drinking problems, coping motivated drinking, depression, and social anxiety. ERI was unrelated to drinking quantity. ERI was indirectly related to drinking and related problems via the sequential effects of depression and coping motivated drinking, but not via depression or coping motives alone. ERI was indirectly related to drinking via the sequential effects of social anxiety and coping motivated drinking, and indirectly related to drinking problems via social anxiety but not via coping motives alone. In line with minority stress-based models, ERI is related to less negative drinking outcomes (less frequent drinking, fewer problems) via less psychological distress (depression, social anxiety) and less coping motivated drinking. Also, social anxiety was robustly related to drinking frequency and problems among Black drinkers, a group that has been underrepresented in the social anxiety-drinking literature. This finding indicates that anxiety about social situations may play an especially important role in drinking behaviors in this group.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA.
| | - Paige E Morris
- Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA; Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, TX, USA; HEALTH Institute, University of Houston, Houston, TX, USA
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11
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Assayag N, Berger I, Parush S, Mell H, Bar-Shalita T. Attention-Deficit/Hyperactivity Disorder Symptoms, Sensation-Seeking, and Sensory Modulation Dysfunction in Substance Use Disorder: A Cross Sectional Two-Group Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052541. [PMID: 35270233 PMCID: PMC8909105 DOI: 10.3390/ijerph19052541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/12/2022] [Accepted: 02/14/2022] [Indexed: 12/23/2022]
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) and sensation-seeking, a trait characterized by risk-related behaviors, have been recognized as risk factors in substance use disorder (SUD). Though ADHD co-occurs with sensory modulation dysfunction (SMD), SMD has scarcely been explored in SUD. Thus, this study aimed to characterize ADHD symptomology, sensation-seeking, and SMD, as well as to explore their contribution to SUD likelihood. Methods: A cross sectional two-group comparative study including therapeutic community residents with SUD (n = 58; study group) and healthy individuals (n = 62; comparison group) applying the MOXO continuous performance test (MOXO-CPT) evaluating ADHD-related symptoms. In addition, participants completed the ADHD Self-Report Scale—Version 1.1 for ADHD screening; the Brief Sensation Seeking Scale quantifying risk-taking behaviors; and the Sensory Responsiveness Questionnaire-Intensity Scale for identifying SMD. Results: The study group demonstrated higher SMD incidence (53.57% vs. 14.52%) and lower performance in three MOXO-CPT indexes: Attention, Impulsivity, and Hyperactivity, but not in Timing, compared to the comparison group. Sensory over-responsiveness had the strongest relationship with SUD, indicating 27-times increased odds for SUD (95% CI = 5.965, 121.216; p ≤ 0.0001). A probability risk index is proposed. Conclusion: We found SMD with the strongest relation to SUD exceeding that of ADHD, thus contributing a new perspective for developing future therapeutic modalities. Our findings highlight the need to address SMD above and beyond ADHD symptomology throughout the SUD rehabilitation.
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Affiliation(s)
- Naama Assayag
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (N.A.); (S.P.)
| | - Itai Berger
- Pediatric Neurology, Pediatric Division, Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8443944, Israel;
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Shula Parush
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112102, Israel; (N.A.); (S.P.)
| | - Haim Mell
- Department of Criminology, Max Stern Yezreel Valley College, Yezreel Valley 1930600, Israel;
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence:
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12
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Trauma and Emotion Regulation: Associations with Depressive Symptoms and Cocaine Use among Treatment-seeking Adults. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00713-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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13
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Tyler S. Transcending the Shadow of Alcoholism. BRITISH JOURNAL OF PSYCHOTHERAPY 2022. [DOI: 10.1111/bjp.12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Berny LM, Tanner-Smith EE. Differential Predictors of Suicidal Ideation and Suicide Attempts: Internalizing Disorders and Substance Use in a Clinical Sample of Adolescents. J Dual Diagn 2022; 18:59-69. [PMID: 34982653 PMCID: PMC8960344 DOI: 10.1080/15504263.2021.2016343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objective: Dually diagnosed adolescents are a high-risk population for experiencing suicidal thoughts and behavior. Given that research suggests risk factors for suicidal ideation and suicide attempts may be different, this study examined whether internalizing disorder severity, frequency of substance use, and the interaction between them differentiated adolescents who attempted suicide from those who ideated. Methods: Baseline data from 287 adolescents who received formal substance use disorder (SUD) treatment were used in this analysis. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) severity as well as past-3 month use of alcohol, cannabis, and other illicit drugs were considered. The outcome of interest was a three-category measure of suicide risk: no reported suicidal ideation or attempts, suicidal ideation only, and suicide attempts. Results: Over half of the sample disclosed prior suicidal ideation (30.0%) or attempts (27.9%). Multinomial logistic regression models indicated more severe MDD and GAD symptomology differentiated ideators from non-suicidal adolescents, but internalizing disorder severity did not differ between ideators and attempters. Substance use frequency did not differ between suicide risk groups. MDD severity and frequency of alcohol use interacted to increase the risk of attempts, yet the effects were minimal. Instead, prior weapon violence victimization and sexual abuse were the largest differentiators between attempters and ideators. Conclusions: Findings suggest that internalizing disorder severity and prior traumatic experiences put adolescents with SUD histories at higher risk of suicidal thoughts and behaviors. Thus, integrating evidence-based suicide prevention and intervention efforts into SUD treatment is critical, particularly for dually diagnosed adolescents who meet these risk profiles. Psychotherapy and medication may help curtail the development of ideation by reducing symptoms of MDD and GAD, whereas adolescents with prior traumatic experiences may benefit from additional treatments shown to lower risk of suicide attempts.
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Affiliation(s)
- Lauren M Berny
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA
| | - Emily E Tanner-Smith
- Department of Counseling Psychology and Human Services, University of Oregon, Eugene, OR, USA.,Prevention Science Institute, University of Oregon, Eugene, OR, USA
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15
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Ethnic discrimination and alcohol-related problem severity among Hispanic/Latin drinkers: The role of social anxiety in the minority stress model. J Subst Abuse Treat 2022; 138:108730. [DOI: 10.1016/j.jsat.2022.108730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/30/2021] [Accepted: 01/19/2022] [Indexed: 11/18/2022]
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16
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Jenzer T, Cheesman AJ, Shaw RJ, Egerton GA, Read JP. Coping Flexibility and Alcohol-Related Outcomes: Examining Coping Motives as Mediators. Subst Use Misuse 2022; 57:2031-2041. [PMID: 36271805 DOI: 10.1080/10826084.2022.2125274] [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: 10/24/2022]
Abstract
Background: Coping has been implicated in the etiology and treatment of problem drinking. Traditional, static measurement of coping styles (e.g., approach, avoidance, social support) may fail to capture how adaptive a given coping style may be. Coping flexibility is an emerging construct, associated with psychological health, and one that may shed light on coping's role in drinking risk. Coping flexibility includes (1) discontinuation of an ineffective coping strategy ("Discontinuation") and (2) production of an alternative strategy ("Implementation"). This study is the first to our knowledge to examine its association to drinking outcomes. Further, because coping deficits are theorized to lead to drinking through coping motives, we also examined mediated pathways from coping flexibility to alcohol outcomes via coping motives. Methods: College students (N = 528) completed an online assessment. Data were analyzed using path analysis. Control variables included sex and coping styles. Results: In path analytic models, Implementation was negatively associated with alcohol use and, indirectly via coping motives, negatively associated with alcohol consequences. The direct effect on alcohol use remained when controlling for coping styles and sex, but the mediational pathway was no longer significant. Conclusions: This study provides some evidence for the protective role of coping flexibility in alcohol use behavior, which may have implications for how best to address coping skills in alcohol interventions. The direct effect of Implementation on drinking suggests that there may be utility in teaching clients a flexible approach to coping in treatment. Replication, particularly with longitudinal designs, is needed.
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Affiliation(s)
- Tiffany Jenzer
- Department of Behavioral and Social Sciences, Brown University School of Public Health.,Department of Psychology, State University of New York - University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Abigail J Cheesman
- Department of Psychology, State University of New York - University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Rachael J Shaw
- Department of Psychology, State University of New York - University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Gregory A Egerton
- Department of Psychology, State University of New York - University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Jennifer P Read
- Department of Psychology, State University of New York - University at Buffalo, State University of New York, Buffalo, New York, USA
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17
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Köck P, Meyer M, Elsner J, Dürsteler KM, Vogel M, Walter M. Co-occurring Mental Disorders in Transitional Aged Youth With Substance Use Disorders - A Narrative Review. Front Psychiatry 2022; 13:827658. [PMID: 35280170 PMCID: PMC8907594 DOI: 10.3389/fpsyt.2022.827658] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/21/2022] [Indexed: 11/28/2022] Open
Abstract
Adolescence and emerging adulthood are often referred to as youth. Transitional psychiatry addresses this target group, which considers patients between 15 and 25 years of age. Substance use usually begins and peaks at this stage of life. Psychiatric disorders, foremost attention-deficit/hyperactivity disorder, and affective disorders, conduct disorders, and first-episodes psychosis frequently appear in early life stages. This review aims to provide a broad overview of transitional-aged youth's most common psychiatric comorbidities with substance use disorders. A literature search was conducted in Embase and Pubmed, and the main findings are described narratively. We present main findings for the following comorbidities: attention-deficit/hyperactivity disorder, conduct disorder, personality disorders, affective disorders, psychotic disorders, and the phenomena of overdose and suicidality. In conclusion, co-occurring mental health disorders are common and appear to facilitate the development of substance use disorders and exacerbate their overall course. Substance use also affects the severity and course of comorbid psychiatric disorders. Overall, data on transition-age youth with substance use disorders are highly inconsistent. Universal screening and treatment guidelines do not yet exist but should be aimed for in the future.
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Affiliation(s)
- Patrick Köck
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Maximilian Meyer
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland
| | - Julie Elsner
- University Psychiatric Clinics Basel, Clinic for Children and Adolescents, University of Basel, Basel, Switzerland
| | - Kenneth M Dürsteler
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Department for Psychiatry, Psychotherapy and Psychosomatic, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Marc Vogel
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Division of Substance Use Disorders, Psychiatric Clinic, Psychiatric Services of Thurgovia, Münsterlingen, Switzerland
| | - Marc Walter
- Department of Addictive Disorders, University Psychiatric Clinics Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
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18
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Flores Mosri D. Affective Neuroscience Contributions to the Treatment of Addiction: The Role of Social Instincts, Pleasure and SEEKING. Front Psychiatry 2021; 12:761744. [PMID: 34887789 PMCID: PMC8649919 DOI: 10.3389/fpsyt.2021.761744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/28/2021] [Indexed: 12/21/2022] Open
Abstract
Addiction is an illness prevalent in the worldwide population that entails multiple health risks. Because of the nature of addictive disorders, users of drugs seldom look for treatment and when they do, availability can be difficult to access. Permanence in treatment and its outcomes vary from case to case. Most models work from a multidisciplinary approach that tackles several dimensions of addictive disorders. However, the different etiological factors claim for a personalized treatment to enhance opportunities for better results. Problems in relationships with others play an important role in the etiology and the recovery process of addiction. This paper focuses on the social-environmental causes of addiction based on an affective neuroscience approach that attempts to integrate the interplay between social instincts, pleasure, and the SEEKING system in addiction. To advance toward better treatment strategies, it is pertinent to understand the limitations of the current multidisciplinary models. Acknowledging the social nature of the human brain may help to identify the quality of different types of traumatic early life experiences in drug users and how to address them in what may become a neuropsychoanalytic treatment of addiction.
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Affiliation(s)
- Daniela Flores Mosri
- Department of Psychology, Psychoanalytic Psychotherapy, Neuropsychoanalysis, Universidad Intercontinental, Mexico City, Mexico
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19
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Buckner JD, Glover NI, Shepherd JM, Zvolensky MJ. Racial Discrimination and Hazardous Drinking among Black Drinkers: The Role of Social Anxiety in the Minority Stress Model. Subst Use Misuse 2021; 57:256-262. [PMID: 34789059 PMCID: PMC9153382 DOI: 10.1080/10826084.2021.2002903] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: Black Americans who consume alcohol experience worse alcohol-related outcomes. Thus, identifying psycho-sociocultural factors that play a role in hazardous drinking among Black individuals is vital to informing prevention and treatment efforts to reduce these disparities. Racial discrimination is related to hazardous drinking among Black adults, suggesting that some may drink (and continue to drink despite drinking-related problems) to alleviate negative affect (e.g., depression, anxiety) associated with discrimination. Yet, despite the social nature of both racial discrimination and drinking, no known research has examined the role of social anxiety in the relations among racial discrimination experiences and hazardous drinking. Method: Participants were 164 Black current drinking undergraduates. Results: Racial discrimination was significantly, positively correlated with hazardous drinking, depression, and social anxiety. Discrimination was indirectly related to hazardous drinking via social anxiety, but not depression. Further, discrimination was indirectly related to hazardous drinking via social anxiety alone and via the sequential effects of social anxiety and drinking to cope, but not via coping motives alone. It was also related to hazardous drinking via the sequential effects of depression and drinking to cope but not depression alone. Alternative model testing indicated that social anxiety was not related to hazardous drinking via discrimination, strengthening confidence in directionality of proposed relations. Conclusions: Negative affect (social anxiety, depression) appears to be related to hazardous drinking among those who experience more discrimination due in part to drinking to cope. Social anxiety plays an important role in the relation between discrimination and hazardous drinking among Black adults.
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20
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Koslowski M, Johnson MW, Gründer G, Betzler F. Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00401-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Abstract
Purpose of Review
The use of psychedelics in a therapeutical setting has been reported for the treatment of various diagnoses in recent years. However, as psychedelic substances are still commonly known for their (illicit) recreational use, it may seem counterintuitive to use psychedelic therapy to treat substance use disorders. This review aims to discuss how psychedelics can promote and intensify psychotherapeutic key processes, in different approaches like psychodynamic and cognitive behavioral therapy, with a spotlight on the treatment of substance use disorders (SUD).
Recent Findings
There is promising evidence of feasibility, safety, and efficacy of psychedelic therapy in SUD. In the whole process of former and current psychedelic therapy regimes that have shown to be safe and efficacious, various psychotherapeutic elements, both psychodynamic and behavioral as well as other approaches, can be identified, while a substantial part of the assumed mechanism of action, the individual psychedelic experience, cannot be distinctly classified to just one approach.
Summary
Psychedelic therapy consists of a complex interaction of pharmacological and psychological processes. When administered in well-defined conditions, psychedelics can serve as augmentation of different psychotherapy interventions in the treatment of SUD and other mental disorders, regardless of their theoretical origin.
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21
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Chuang DM, Newman PA, Fang L, Lai MC. Syndemic Conditions, Sexual Risk Behavior, and HIV Infection Among Men Who Have Sex with Men in Taiwan. AIDS Behav 2021; 25:3503-3518. [PMID: 33950337 DOI: 10.1007/s10461-021-03269-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
Men who have sex with men (MSM) continue to constitute the majority of HIV incidence in Taiwan. This study examined the associations between five co-occurring psychosocial health conditions (PHCs)-childhood physical abuse (CPA), childhood sexual abuse (CSA), intimate partner violence (IPV), internalized homophobia (IH), and methamphetamine use (MU), and two outcomes (HIV infection and condomless anal sex) among a community sample of 1,000 Taiwanese MSM (mean age 28.5 years). Compared to MSM who had never experienced any PHC, MSM with one or more PHCs had greater than twofold higher odds of being HIV-positive, and those with three or more PHCs had twofold higher odds of having condomless anal sex. Interactive effects on HIV infection were identified from CPA + CSA + MU and CPA + IPV + MU. An interactive effect on condomless anal sex was detected between IH and MU. In order to control the escalating HIV epidemic among MSM in Taiwan, interventions are needed to address syndemic psychosocial health conditions.
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Affiliation(s)
- Deng-Min Chuang
- Graduate Institute of Social Work, National Taiwan Normal University, No. 162, Sec. 1, Heping E. Rd., Da'an Dist., Taipei, 106, Taiwan, ROC.
| | - Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Meng-Chuan Lai
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Azrieli Adult Neurodevelopmental Centre, and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
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22
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Yang HM, Kim HR. Depression as a Mediator in the Association of Work-Family Conflict With Problem Drinking Among Young and Middle-Aged Korean Married Workers. J Occup Environ Med 2021; 62:1029-1033. [PMID: 33009072 DOI: 10.1097/jom.0000000000002038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This study examined the associations of work-family conflicts (WFC) with problem drinking and the mediating effect of depression among Korean married workers. METHODS The data of 2386 married workers were used from the 2017 Korean Welfare Panel Study. The data classified into two groups, young adults and middle-aged based on age 45. The association of WFC with problem drinking and the mediating effect of depression was assessed by combining logistic and linear regression. RESULTS WFC was associated with problem drinking, and the mediating effect of depression was significant in the middle-aged group. Meanwhile, depression only has a direct effect on problem drinking in the young adult group. CONCLUSION A strategy for treating depression may be important for countering problem drinking. However, an age-tailored intervention should be considered WFC supporting middle-aged workers.
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Affiliation(s)
- Hwa-Mi Yang
- College of Nursing, ShinHan University, Dongducheon-si, Republic of Korea
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23
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Livingston NA, Lee DJ, Mahoney CT, Farmer SL, Cole T, Marx BP, Keane TM. Longitudinal assessment of PTSD and illicit drug use among male and female OEF-OIF veterans. Addict Behav 2021; 118:106870. [PMID: 33667852 DOI: 10.1016/j.addbeh.2021.106870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) and substance use share both directional ("self-medication") and mutually-reinforcing associations over time. Research on gender differences regarding the co-occurrence of PTSD and substance use over time remains limited and largely focused on alcohol use; less is known regarding the co-occurrence of PTSD and illicit drug use, especially among veteran men vs. women. As the proportion of women in the military expands, we believe a greater focus on gender differences is warranted. METHOD We conducted a cross-lagged panel analysis of PTSD symptoms and drug use problems using two waves of data from a large, nationwide longitudinal registry of post-9/11 veterans. Participants included 608 men and 635 women (N = 1243; Mage = 42.3; 75.2% White) who completed self-report PTSD and drug use problem questionnaires at T1 and again at T2 15-37 months later. RESULTS Veteran men reported more severe drug use and related problems overall, yet the cross-sectional correlation between PTSD and drug use problems was strongest among drug using veteran women. In our cross-lagged models, we found that PTSD symptoms predicted future drug use problems among veteran men, whereas drug use problems predicted future PTSD symptom severity among women. CONCLUSIONS These results support the self-medication pathway among veteran men but not women, for whom drug use problems might prolong or exacerbate PTSD symptom severity over time. These results are consistent with some emerging evidence but also provide novel insight into functional associations governing the longitudinal course of PTSD and drug use problems for men vs. women.
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Affiliation(s)
- Nicholas A Livingston
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States.
| | - Daniel J Lee
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Colin T Mahoney
- Western New England University, Springfield, MA, United States
| | - Stacey L Farmer
- Department of Veteran Affairs, Albany Stratton VA Medical Center, Albany, NY, United States
| | - Travis Cole
- National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Brian P Marx
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Terence M Keane
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
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24
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Yamashita A, Yoshioka SI, Yajima Y. Resilience and related factors as predictors of relapse risk in patients with substance use disorder: a cross-sectional study. Subst Abuse Treat Prev Policy 2021; 16:40. [PMID: 33947412 PMCID: PMC8097930 DOI: 10.1186/s13011-021-00377-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Resilience, referring to the inherent ability to naturally recover in the face of adverse conditions, is an essential concept in discussions of substance use disorder (SUD) recovery. This study's objective was to shed light on resilience and related factors that affect relapse risk in patients with SUDs. METHOD Fifty-two patients with SUDs were given a self-administrated questionnaire from February to April 2015 consisting of question items for sociodemographic characteristics, relapse risk (Stimulant Relapse Risk Scale), and resilience (Bidimensional Resilience Scale). Scale scores were tested for associations with subject attributes, after which resilience's effects on relapse risk were analyzed using correlation and multiple regression (forced-entry) analyses. RESULTS Stimulants were the most common substance related to SUD (n = 26, 21.7%; multiple answers). Bivariate correlation showed that higher acquired resilience was significantly associated with a lower relapse risk (r = - 0.314, P < 0.01). Reduced relapse risk was significantly associated with current employment (Std. β = - 0.446, P < 0.05). CONCLUSION Our findings demonstrate the necessity of recovery support to enhance acquired resistance in patients with SUDs to prevent relapses. Reinforcing employment support services and encouraging patients to continue treatment were suggested as potentially effective measures to enhance resilience in individuals with SUDs on their road to recovery.
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Affiliation(s)
- Ayako Yamashita
- Faculty of Medicine, School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Shin-Ichi Yoshioka
- Faculty of Medicine, School of Health Science, Tottori University, Yonago, Japan
| | - Yuki Yajima
- Department of Nursing, Faculty of Human Health Sciences, Niimi University, Niimi, Japan
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25
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Bettmann JE, Kouris GM, Anderson IM, Casselman B. Wilderness as Healing Environment: Treating Adolescent Substance Misuse in Wilderness Therapy. PSYCHOANALYTIC STUDY OF THE CHILD 2021. [DOI: 10.1080/00797308.2020.1859270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Terrone G, Gori A, Topino E, Musetti A, Scarinci A, Guccione C, Caretti V. The Link between Attachment and Gambling in Adolescence: A Multiple Mediation Analysis with Developmental Perspective, Theory of Mind (Friend) and Adaptive Response. J Pers Med 2021; 11:228. [PMID: 33810022 PMCID: PMC8005040 DOI: 10.3390/jpm11030228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 12/16/2022] Open
Abstract
Introduction: Several studies have supported the evidence that attachment styles are a central factor in adolescent gambling problems. On this theoretical basis, the aim of the present study is to analyze a hypothesized mediation model exploring both the direct and indirect effects of insecure attachment on gambling disorder by investigating the role of the developmental perspective, theory of mind (friend) and adaptive response in that relationship. Method: The sample consists of 178 adolescents who underwent the Measures: South Oaks Gambling Screen-Revised for Adolescents and Friends and Family Interview. Result: The mediation analysis was conducted following Hayes' (2018) procedure, using Model 6. The results showed a significant association between insecure attachment and gambling disorder (β = 0.669; p < 0.001). The findings also highlighted a significant chained mediation model in which insecure attachment negatively influenced the developmental perspective (β = -0.742; p < 0.001), which affected the theory of mind toward one's own best friend (β = 0.352; p < 0.001). Conclusions: The results highlighted a significant role of insecure attachment in predicting the symptomatic expression of gambling among adolescents, specifically impacting the development perspective, theory of mind toward one's best friend and adaptive response to stress, which were linked to each other by a sequential influence. Therefore, our results showed that a poor developmental self-vision predicted a dysfunctional theory of mind toward the best friend. This could hinder the formation of positive peer relationships, which are crucial for the development of one's identity.
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Affiliation(s)
- Grazia Terrone
- Department of History, Cultural Heritage, Education and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Alessio Gori
- Department of Human Sciences, University of Florence, 50100 Florence, Italy;
| | - Eleonora Topino
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, 43121 Parma, Italy;
| | - Alessia Scarinci
- Department of Education Sciences, Psychology, Communication, University of Bari, 70121 Bari, Italy;
| | - Camilla Guccione
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
| | - Vincenzo Caretti
- Department of Human Sciences, Lumsa University of Rome, 00185 Rome, Italy; (E.T.); (C.G.); (V.C.)
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McCabe CT, Watrous JR, Galarneau MR. Health Behaviors Among Service Members Injured on Deployment: A Study From the Wounded Warrior Recovery Project. Mil Med 2021; 186:67-74. [PMID: 33005930 DOI: 10.1093/milmed/usaa242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/06/2020] [Accepted: 08/03/2020] [Indexed: 01/12/2023] Open
Abstract
ABSTRACT
Introduction
Service members (SMs) who are injured on deployment are at risk for myriad long-term health problems that may be ancillary to their physical injury, including high rates of depression and posttraumatic stress disorder, and poor health behaviors (e.g., problem drinking, cigarette and tobacco use, poor sleep quality, and sedentary lifestyle). As the specific health behaviors injured SMs engage in have been largely ignored, the primary aim of this study was to compare health behavior patterns among those with and without mental health problems in a large, representative sample of SMs injured on combat deployment.
Materials and Methods
Participants (N = 3,303) completed behavioral health assessments between September 2018 and April 2019 as part of the Wounded Warrior Recovery Project. Multivariate linear regressions and binary logistic regressions were used to evaluate differences between mental health screening status and health behavior outcomes, adjusting for injury severity, age, and years since injury.
Results
Overall, about half of participants screened positive for posttraumatic stress disorder and/or depression (49%). Participants reported high rates of alcohol use and problems, cigarette and tobacco use, inadequate sleep and poor sleep quality, and low levels of physical activity. With the exception of number of drinking days and likelihood of current tobacco use, participants who screened positive for a mental health disorder evidenced significantly worse health behavior outcomes.
Conclusions
The results provide a preliminary glance into the mental health and health behaviors of SMs roughly a decade after injury, and underscore the importance of examining the interplay between mental, physical, and behavioral health outcomes among wounded warriors to promote health and wellness.
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Affiliation(s)
- Cameron T McCabe
- Operational Readiness Directorate, Naval Health Research Center, San Diego, CA 92106, USA
- Leidos, San Diego, CA 92106, USA
| | - Jessica R Watrous
- Operational Readiness Directorate, Naval Health Research Center, San Diego, CA 92106, USA
- Leidos, San Diego, CA 92106, USA
| | - Michael R Galarneau
- Operational Readiness Directorate, Naval Health Research Center, San Diego, CA 92106, USA
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Mahoney CT, Moshier SJ, Keane TM, Marx BP. Heightened healthcare utilization & risk of mental disorders among Veterans with comorbid opioid use disorder & posttraumatic stress disorder. Addict Behav 2021; 112:106572. [PMID: 32861102 DOI: 10.1016/j.addbeh.2020.106572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/24/2020] [Accepted: 07/21/2020] [Indexed: 12/01/2022]
Abstract
Although Veterans with posttraumatic stress disorder (PTSD) are vulnerable to opioid misuse, there is limited research evaluating the psychosocial and medical sequalae experienced by Veterans with comorbid PTSD and opioid use disorder (OUD). Using data from a nationwide, longitudinal registry of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) Veterans oversampled for PTSD with a 1:1 ratio of men to women, we identified Veterans with lifetime diagnoses of comorbid PTSD and OUD (n = 40), PTSD and non-opioid substance use disorder (SUD; n = 386), PTSD only (n = 901), and non-opioid SUD only (n = 52) using medical record data. We then compared these groups on Veterans Affairs emergency, urgent care, and inpatient healthcare utilization, suicide risk, functional impairment, and the presence of comorbid mental conditions in the following 1-2 years. Relative to all other groups, Veterans with comorbid OUD and PTSD had increased likelihood of emergency room and inpatient care, probable somatoform and major depressive disorders, and greater functional impairment. Both the PTSD/OUD group and PTSD/non-opioid SUD group demonstrated increased suicidality, urgent care utilization, and probable generalized anxiety disorder relative to Veterans with PTSD only or non-opioid SUD only. Results suggest that comorbid OUD and PTSD are associated with greater likelihood of negative psychiatric and healthcare related outcomes, even relative to PTSD comorbid with other types of SUDs. Findings support the importance of concentrated and sustained efforts to improve prevention and intervention strategies for Veterans struggling with PTSD symptoms and opioid misuse.
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Affiliation(s)
- Colin T Mahoney
- VA Boston Healthcare System, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | | | - Terence M Keane
- VA Boston Healthcare System, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Brian P Marx
- VA Boston Healthcare System, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States.
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Brem MJ, Shorey RC, Anderson S, Stuart GL. Dispositional Mindfulness and Aggression Among Adults in Residential Treatment for Opioid Use Disorder: Preliminary Findings From an Applied Setting. VIOLENCE AND VICTIMS 2020; 35:828-840. [PMID: 33372112 DOI: 10.1891/vv-d-18-00036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Individuals with opioid use disorder (OUD) evidenced high levels of aggression both before and after the onset of opioid misuse. Continued aggression after abstinence suggested that abstinence alone may be inadequate. The present study investigated dispositional mindfulness in relation to aggressive attitudes, and verbal and physical aggression, by reviewing medical records of 163 adults in residential treatment for OUD. Results of hierarchical regression analyses, controlling for age and alcohol/drug use and problems, revealed a negative relationship between dispositional mindfulness and both aggressive attitudes and verbal aggression. Although dispositional mindfulness negatively related to physical aggression at the bivariate level, only alcohol use and problems related to physical aggression in regression analyses. Mindfulness-based treatments may be a useful avenue for targeting aggression within this population.
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Affiliation(s)
- Meagan J Brem
- Department of Psychology, University of Tennessee, Knoxville, TN
| | - Ryan C Shorey
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI
| | - Scott Anderson
- Clinical Director/Chief Clinical Officer of Cornerstone of Recovery, Louisville, TN
| | - Gregory L Stuart
- Department of Psychology, University of Tennessee, Knoxville, TN
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30
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Assayag N, Bonneh Y, Parush S, Mell H, Kaplan Neeman R, Bar-Shalita T. Perceived Sensitivity to Pain and Responsiveness to Non-noxious Sensation in Substance Use Disorder. PAIN MEDICINE 2020; 21:1902-1912. [PMID: 31782772 DOI: 10.1093/pm/pnz292] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This comparative cross-sectional study aimed to characterize individuals with substance use disorder (SUD) in self-perception of pain sensitivity, experimental auditory aversiveness, and non-noxious sensory responsiveness, as well as examine the associations with SUD. METHODS Therapeutic community (TC) individuals with SUD (N = 63, male 88.9%) and healthy controls (N = 60, male 86.7%) completed the Pain Sensitivity Questionnaire (PSQ) and the Sensory Responsiveness Questionnaire-Intensity Scale (SRQ-IS), followed by a psychophysical auditory battery, the Battery of Averseness to Sounds (BAS)-Revised. RESULTS The SUD group scored higher on the PSQ (P < 0.0001), BAS-R aversiveness (P < 0.0001), BAS-R-unpleasantness (P < 0.0001), and on the aftersensation of auditory aversiveness (P < 0.0001) and unpleasantness (P < 0.000). Fifty-four percent of the SUD group vs 11.7% of the control group were identified as having sensory modulation dysfunction (SMD; P < 0.0001). Logistic regression modeling revealed that the SRQ-IS-Aversive score had a stronger relationship, indicating a 12.6-times odds ratio for SUD (P = 0.0002). Finally, a risk score calculated from a linear combination of the logistic regression model parameters is presented based on the PSQ and SRQ. CONCLUSIONS This is the first study to explore sensory and aversive domains using experimental and self-reporting in situ, revealing pain perception alteration that co-occurs with high prevalence of SMD, specifically of the over-responsive type. Findings may be significant in clinical practice for treating pain, and for expanding therapeutic modalities as part of broader rehabilitation in TC and beyond, to better meet personalized therapy.
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Affiliation(s)
- Naama Assayag
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Yoram Bonneh
- School of Optometry and Vision Science, Mina & Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel
| | - Shula Parush
- Faculty of Medicine, School of Occupational Therapy, Hadassah and Hebrew University, Jerusalem, Israel
| | - Haim Mell
- Yezreel Valley College, Afula, Israel
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Mahoney CT, Iverson KM. The Roles of Alcohol Use Severity and Posttraumatic Stress Disorder Symptoms as Risk Factors for Women's Intimate Partner Violence Experiences. J Womens Health (Larchmt) 2020; 29:827-836. [PMID: 31905315 PMCID: PMC7307688 DOI: 10.1089/jwh.2019.7944] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: To reduce women's risk for intimate partner violence (IPV), it is critical to elucidate malleable psychiatric and behavioral health risk factors. We aimed to identify if alcohol use problems moderate the associations between posttraumatic stress disorder (PTSD) symptoms and past-year IPV victimization experiences among female veterans, a population at high risk for IPV. Methods: Female veterans (N = 198) completed mail surveys assessing PTSD symptoms, alcohol use, and IPV at two time points between 2012 and 2013. Regression analyses were used to examine the associations between PTSD symptoms and alcohol use at Time 1 with past-year IPV at Time 2. Results: More than a third of women (36.9%) reported past-year IPV. Alcohol use severity significantly moderated the association between PTSD symptoms and past-year physical IPV. Specifically, there was a significant positive association between PTSD symptoms and past-year IPV at high levels of alcohol use severity, but not at low or average levels of alcohol use. Although both PTSD symptoms and alcohol use were independent risk factors for past-year sexual and psychological IPV, no moderating effect was found for these IPV types. Conclusions: Findings can inform tailored IPV, psychiatric, and behavioral health screening and counseling. Such practices may reduce psychiatric distress and IPV risk.
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Affiliation(s)
- Colin T. Mahoney
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
| | - Katherine M. Iverson
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
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Mooney A, Roberts A, Bayston A, Bowden‐Jones H. The piloting of a brief relational psychodynamic protocol (psychodynamic addiction model) for problem gambling and other compulsive addictions: A retrospective analysis. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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The Minnesota Model: A Clinical Assessment of Its Effectiveness in Treating Anxiety and Depression Compared to Addiction. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AbstractThe current study compared and assessed the effectiveness of the Minnesota model in reducing psychological symptoms of anxiety and depression among two groups: individuals with clinically diagnosed addiction only (n = 29) and individuals with clinically diagnosed anxiety/depression in the absence of addiction (n = 25). Anxiety and depression were measured using the Generalised Anxiety Disorder 7 and the Patient Health Questionnaire 9, respectively. Two one-way analyses of covariance found no significant differences in post-intervention anxiety and depression scores when comparing the addiction group and the anxiety/depression group (F(1, 51) = 0.075, p = 0.786 and F(1, 51) = 0.302, p = 0.585, respectively). Reliable change index calculations also indicated that both the addiction group and the anxiety/depression group exhibited clinically significant reductions in anxiety and depression following treatment. These findings are considered in light of key methodological limitations, and the theoretical and therapeutic implications are discussed.
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Flores Mosri D. Affective Features Underlying Depression in Addiction: Understanding What It Feels Like. Front Psychol 2019; 10:2318. [PMID: 31681110 PMCID: PMC6811663 DOI: 10.3389/fpsyg.2019.02318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/27/2019] [Indexed: 12/21/2022] Open
Abstract
Addiction poses a complex challenge in spite of all the progress made toward understanding and treating it. A multidisciplinary approach is needed and this paper attempts to integrate relevant neurobiological, behavioral, and subjective data under a common denominator described as a latent type of depression. It is called latent because it remains a silent syndrome due to two main reasons. The first one relates to the natural use of defenses against a predominant effect of chronic subjective pain, which arises from an ambivalent type of separation distress that compromises opioid regulation (PANIC system). Furthermore, it provokes a neurochemical cascade that impacts several neuromodulatory systems. The second reason is that such chronic subjective pain usually exhausts the natural defensive system, frequently leading the person to look for other resources such as the neurochemical manipulation of psychic pain. Thus, both the use of defenses and of psychotoxic drugs make the underlying depression hard to assess, even for the very person suffering from it. The causes, course and treatment of this type of affective configuration are discussed in this paper as an attempt to explain some of the difficulties so far encountered and to contribute to potential alternative lines of treatment.
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Affiliation(s)
- Daniela Flores Mosri
- Department of Psychology, Psychoanalytic Psychotherapy, Neuropsychoanalysis, Universidad Intercontinental, Mexico City, Mexico
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Psederska E, Savov S, Atanassov N, Vassileva J. Relationships Between Alexithymia and Psychopathy in Heroin Dependent Individuals. Front Psychol 2019; 10:2269. [PMID: 31649591 PMCID: PMC6794427 DOI: 10.3389/fpsyg.2019.02269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 09/23/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Psychopathy and substance use disorders are highly co-morbid and their co-occurrence is associated with higher severity of addictive behavior and increased risk of violent offending. Both substance use disorders and psychopathy are related to prominent impairments in emotion processing, which are also central features of alexithymia. The nature of the relationship between psychopathy and alexithymia is not well-understood and has been particularly understudied among substance dependent individuals. AIM Our goal was to evaluate the levels of psychopathy and alexithymia in a relatively homogeneous sample of heroin dependent individuals (HDIs) and healthy controls and to examine group differences in the pattern of associations between these constructs. METHODS We examined 62 participants (31 heroin dependent individuals and 31 healthy controls) with the Psychopathy Checklist: Screening version (PCL:SV, Hart et al., 1995) and the Toronto Alexithymia Scale-20 (TAS-20, Bagby et al., 1994). RESULTS Heroin dependent individuals were characterized by higher levels of both psychopathy and alexithymia as compared to the control group. In addition, HDIs with higher levels of psychopathy reported more difficulties in identifying and verbalizing emotional states. In the heroin group, alexithymia was more strongly associated with the impulsive/antisocial characteristics (impulsivity, irresponsibility, antisocial behavior) than with the interpersonal/affective features of psychopathy (grandiosity, manipulativeness, lack of empathy, and remorse). CONCLUSION Our findings suggest that alexithymia may be one potential mechanism linking psychopathy with opioid use disorders. The development of interventions targeting alexithymia could have significant applications in relapse prevention programs and psychotherapy of substance use disorders with concurrent psychopathy.
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Affiliation(s)
- Elena Psederska
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
- Bulgarian Addictions Institute, Sofia, Bulgaria
| | - Svetoslav Savov
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | - Nikola Atanassov
- Department of Cognitive Science and Psychology, New Bulgarian University, Sofia, Bulgaria
| | - Jasmin Vassileva
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
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McCabe CT, Mohr CD, Hammer LB, Carlson KF. PTSD Symptomology and Motivated Alcohol Use Among Military Service Members: Testing a Conditional Indirect Effect Model of Social Support. Subst Use Misuse 2019; 54:257-270. [PMID: 30372358 DOI: 10.1080/10826084.2018.1517176] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) and problematic alcohol use commonly co-occur among military service members. It remains critical to understand why these patterns emerge, and under what conditions. OBJECTIVES This study examined whether PTSD symptoms (PTSS) and alcohol involvement (quantity and frequency of use, heavy episodic drinking, and alcohol problems) are indirectly related through four distinct drinking motivations. A secondary aim was to identify factors, specifically forms of social support, which buffer these associations. METHODS Using baseline data from a randomized-controlled trial of health and well-being among civilian-employed separated service members and reservists, the present study examined these issues using a subsample of 398 current drinkers. RESULTS Parallel mediation models revealed PTSS-alcohol consumption associations were indirect through coping and enhancement motivations. PTSS was only related to alcohol problems through coping motivations. In addition, the indirect effect of PTSS on average level of consumption via coping motives was conditional on perceived support from friends and family, whereas the indirect effect for alcohol problems was conditional only on friend support. In contrast, the indirect effects of PTSS on alcohol consumption variables (but not problems) via enhancement motives were conditional on perceived support from friends and family. Conclusions/Importance: Future research and screening efforts should attend to individual motivations for drinking as important factors related to alcohol use and problems among service members experiencing PTSS, and emphasize the importance of communication, trust, and effective supports among military and nonmilitary friends and family.
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Affiliation(s)
- Cameron T McCabe
- a Department of Psychology , Portland State University , Portland , Oregon , USA
| | - Cynthia D Mohr
- a Department of Psychology , Portland State University , Portland , Oregon , USA
| | - Leslie B Hammer
- a Department of Psychology , Portland State University , Portland , Oregon , USA.,b Oregon Institute of Occupational Health Sciences , Oregon Health & Science University , Portland , Oregon , USA
| | - Kathleen F Carlson
- c Veterans Affairs (VA) Portland Healthcare System , Oregon Health & Science University , Portland , Oregon , USA.,d School of Public Health , Oregon Health & Science University , Portland , Oregon , USA
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37
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Mc Donnell E, Hevey D, McCauley M, Ducray KN. Exploration of Associations Between Early Maladaptive Schemas, Impaired Emotional Regulation, Coping Strategies and Resilience in Opioid Dependent Poly-Drug Users. Subst Use Misuse 2018; 53:2320-2329. [PMID: 29889648 DOI: 10.1080/10826084.2018.1473438] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND Early Maladaptive Schema (EMS) are self-beliefs regarding oneself, others and the world, developed in childhood as the result of cumulative negative experiences (Young, 1993). High levels of EMS are present in the opioid using population along with high levels of emotional dysregulation and maladaptive coping alongside traits of resilience. OBJECTIVES The study explored the associations between EMS in relation to emotional dysregulation, maladaptive coping, adaptive coping and resilience between a clinical group composed of opioid dependent polydrug users attending a facility for opioid substitution treatment (n = 52) and a healthy comparison group (n = 70). METHODS A cross-sectional design was used to compare group differences using MANOVAs, and multiple regression analysis identified associations between EMS and emotional dysregulation, coping and resilience. RESULTS The groups significantly differed in relation to emotional dysregulation, maladaptive coping, adaptive coping and resilience. Specific EMS were significant independent predictors in regards to high emotional dysregulation, maladaptive coping, adaptive coping and resilience. CONCLUSION EMS appear to have a significant impact on emotional dysregulation, coping and resilience. Clinical implications suggest that EMS should be addressed when treating opioid dependent polydrug users.
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Affiliation(s)
- Emma Mc Donnell
- a Department of Clinical Psychology, Trinity College , Dublin , Ireland
| | - David Hevey
- a Department of Clinical Psychology, Trinity College , Dublin , Ireland
| | - Mathew McCauley
- a Department of Clinical Psychology, Trinity College , Dublin , Ireland
| | - Kevin Noel Ducray
- a Department of Clinical Psychology, Trinity College , Dublin , Ireland
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Copeland M, Fisher JC, Moody J, Feinberg ME. Different Kinds of Lonely: Dimensions of Isolation and Substance Use in Adolescence. J Youth Adolesc 2018; 47:1755-1770. [PMID: 29774451 PMCID: PMC6045973 DOI: 10.1007/s10964-018-0860-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 10/16/2022]
Abstract
Social isolation is broadly associated with poor mental health and risky behaviors in adolescence, a time when peers are critical for healthy development. However, expectations for isolates' substance use remain unclear. Isolation in adolescence may signal deviant attitudes or spur self-medication, resulting in higher substance use. Conversely, isolates may lack access to substances, leading to lower use. Although treated as a homogeneous social condition for teens in much research, isolation represents a multifaceted experience with structurally distinct network components that present different risks for substance use. This study decomposes isolation into conceptually distinct dimensions that are then interacted to create a systematic typology of isolation subtypes representing different positions in the social space of the school. Each isolated position's association with cigarette, alcohol, and marijuana use is tested among 9th grade students (n = 10,310, 59% female, 83% white) using cross-sectional data from the PROSPER study. Different dimensions of isolation relate to substance use in distinct ways: unliked isolation is associated with lower alcohol use, whereas disengagement and outside orientation are linked to higher use of all three substances. Specifically, disengagement presents risks for cigarette and marijuana use among boys, and outside orientation is associated with cigarette use for girls. Overall, the adolescents disengaged from their school network who also identify close friends outside their grade are at greatest risk for substance use. This study indicates the importance of considering the distinct social positions of isolation to understand risks for both substance use and social isolation in adolescence.
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Affiliation(s)
| | | | - James Moody
- Duke University, Durham, NC, USA
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mark E Feinberg
- The Pennsylvania State University, University Park, PA, 16801, USA
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Habecker P, Welch-Lazoritz M, Dombrowski K. Rural and Urban Differences in Nebraskans’ Access to Marijuana, Methamphetamine, Heroin, and Prescription Pills. JOURNAL OF DRUG ISSUES 2018. [DOI: 10.1177/0022042618786717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ability of a user to access a given type of drug is related to the configuration of the market for that drug, and a range of economic and criminal justice concerns. This study focuses on Nebraskan’s “ready access” to four types of drugs (marijuana, methamphetamine, heroin, and prescription pills) in 2016, using a statewide survey of housed Nebraskan adults. Ready access is defined as a participant knowing at least one person from whom they could obtain a given type of drug if they wanted to. We found that 35% of adult Nebraskans knew at least one person from whom they could obtain marijuana, 8.9% for methamphetamine, 4.5% for heroin, and 17.8% knew at least one source for prescription pills. Relationships between knowing a source for each type of drug and rurality, sex, race, religious attendance, mental health symptoms, and education are explored.
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Cox S, Bertoux M, Turner JJD, Moss A, Locker K, Riggs K. Aspects of alcohol use disorder affecting social cognition as assessed using the Mini Social and Emotional Assessment (mini-SEA). Drug Alcohol Depend 2018; 187:165-170. [PMID: 29674250 DOI: 10.1016/j.drugalcdep.2018.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 03/08/2018] [Accepted: 03/08/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is associated with problems with processing complex social scenarios. Little is known about the relationship between distinct AUD-related factors (e.g., years of problematic drinking), aspects of cognitive function and dysfunction in individuals diagnosed with AUD, and the relative impact these may have on social cognition. AIMS To explore differences in social cognition between a group of participants diagnosed with AUD and controls, using a clinical measure, the Mini Social and Emotional Assessment (mini-SEA). The mini-SEA was used to evaluate social and emotional understanding through a facial emotional recognition task and by utilising a series of social scenes some of which contain a faux pas (social error). METHODS Eighty-five participants (individuals with AUD and controls) completed demographic questions and a general cognitive and social cognitive test battery over three consecutive days. RESULTS Between group analyses revealed that the participants with AUD performed less well on the faux pas test, and differences were also revealed in the emotional facial recognition task. Years of problematic alcohol consumption was the strongest predictor of poor ToM reasoning. CONCLUSION These results suggest a strong link between AUD chronicity and social cognition, though the direction of this relationship needs further elucidation. This may be of clinical relevance to abstinence and relapse management, as basic social cognition skills and ability to maintain interpersonal relationships are likely to be crucial to recovery.
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Affiliation(s)
- Sharon Cox
- London South Bank University, Centre for Addictive Behaviours Research, Division of Psychology, 103 Borough Road, London, SE1 0AA, UK
| | - Maxime Bertoux
- Lille University Hospital, Memory Research and Resources centre & INSERM, U1171, France
| | - John J D Turner
- University of East London, School of Psychology, Water Lane, London, E15 4LZ, UK.
| | - Antony Moss
- London South Bank University, Centre for Addictive Behaviours Research, Division of Psychology, 103 Borough Road, London, SE1 0AA, UK
| | - Kirsty Locker
- Oxleas NHS Foundation Trust, Pinewood Place, Dartford, Kent, DA2 7WG, UK
| | - Kevin Riggs
- University of Hull, Department of Psychology, Cottingham Road, Hull, HU6 7RX, UK
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Raouna A, Osam CS, MacBeth A. Clinical staging model in offspring of parents with bipolar disorder: a systematic review. Bipolar Disord 2018; 20:313-333. [PMID: 29446217 DOI: 10.1111/bdi.12604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 12/09/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We sought to systematically review the literature on the psychiatric risk of offspring of parents with bipolar disorder (OPBD) using a developmental psychopathology framework. The review also sought to establish the utility of clinical stage modelling as a framework for identifying precursor disorders to later onset of bipolar disorder (BD) in OPBD. METHODS A systematic search was performed using EMBASE, PsychINFO and Medline. Reference lists of included studies and previous reviews were also searched. Studies were included if they reported diagnostic outcomes for child, adolescent and young adult offspring of parents diagnosed with BD. RESULTS Twenty-six studies were identified representing 21 individual cohorts. The review identified that OBPD present as a high-risk group for a range of mood and non-mood disorders in childhood, adolescence and young adulthood. The trajectory of risk was from non-mood disorders in childhood via non-bipolar mood disorders in early adolescence towards mania/hypomania in late adolescence and early adulthood. From a clinical staging perspective, childhood anxiety disorders were associated with later onset of BD. Recurrent substance use disorder was identified as a risk in OPBD during late adolescence and early adulthood. Quality ratings indicated that studies were methodologically robust. CONCLUSIONS Our review provides evidence for a developmental psychopathology trajectory of precursor risks to BD in OPBD. There is support for clinical stage modelling as a conceptual framework for understanding developmental risk in OPBD and as a tool for developing early and individualized intervention strategies.
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Affiliation(s)
- Aigli Raouna
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
| | - Cemre Su Osam
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
| | - Angus MacBeth
- Department of Clinical and Health Psychology, University of Edinburgh, Edinburgh, UK
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Pinedo M, Burgos JL, Zúñiga ML, Perez R, Macera CA, Ojeda VD. Deportation and mental health among migrants who inject drugs along the US-Mexico border. Glob Public Health 2018; 13:211-226. [PMID: 27132880 PMCID: PMC5191974 DOI: 10.1080/17441692.2016.1170183] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study describes the prevalence and factors of depressive symptoms among a sample of persons who inject drugs (PWID) with a history of deportation from the US in Tijuana, Mexico. In 2014, 132 deported PWID completed a structured questionnaire. Depressive symptoms were measured using the Center for Epidemiologic Studies Short Depression Scale (CESD-10) screening instrument. Eligible participants were ≥18 years old, injected drugs in the past month, spoke English or Spanish, and resided in Tijuana. Multivariate analyses identified factors associated with depressive symptoms. Among deported PWID, 45% reported current symptoms of depression. Deported PWID who were initially detained in the US for a crime-related reason before being deported (adjusted odds ratio (AOR): 5.27; 95% CI: 1.79-15.52) and who perceived needing help with their drug use (AOR: 2.15; 95% 1.01-4.61) had higher odds of reporting depressive symptoms. Our findings highlight the need for effective strategies targeting deported migrants who inject drugs to treat mental health and drug abuse in Tijuana. Investing in the mental health of deported PWID may also be a viable HIV prevention strategy.
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Affiliation(s)
- Miguel Pinedo
- Alcohol Research Group, 6475 Christie Avenue Suite 400, Emeryville, CA 94608
| | - José Luis Burgos
- Division of Global Public Health, Department of Medicine, University of California, San Diego, Institute of the Americas, 10111 N. Torrey Pines Road, Mail Code 0507, La Jolla, CA 92093
| | - María Luisa Zúñiga
- School of Social Work, San Diego State University, Hepner Hall 203D, San Diego, CA 92182
| | - Ramona Perez
- Department of Anthropology, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-6022
| | - Caroline A. Macera
- School of Public Health, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182-4162
| | - Victoria D. Ojeda
- Division of Global Public Health, Department of Medicine, University of California, San Diego, Institute of the Americas, 10111 N. Torrey Pines Road, Mail Code 0507, La Jolla, CA 92093
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Tretter F, Löffler-Stastka H. Steps Toward an Integrative Clinical Systems Psychology. Front Psychol 2018; 9:1616. [PMID: 30283371 PMCID: PMC6157403 DOI: 10.3389/fpsyg.2018.01616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 08/13/2018] [Indexed: 02/05/2023] Open
Abstract
Clinical fields of the "sciences of the mind" (psychotherapy, psychiatry, etc.) lack integrative conceptual frameworks that have explanatory power. Mainly descriptive-classificatory taxonomies like DSM dominate the field. New taxonomies such as Research Domain Criteria (RDoC) aim to collect scientific knowledge regarding "systems" for "processes" of the brain. These terms have a supradisciplinary" meaning if they are considered in context of Systems Science. This field emerges as a platform of theories like general systems theory, catastrophe theory, synergetics, chaos theory, etc. It provides a lot of abstract concepts, constructs, methods and models. We assume that these tools also enable theoretical integration in the diversified field of clinical practice in the sciences of the mind. Additionally, systems thinking in clinical psychology improves conceptual links to currently network-oriented neurobiology. However, clear definitions of systemic terms are necessary to emerge from their mainly metaphorical use. Here we revise mainly terms like "structure", "process" and "dynamics" as they are used already in psychology, psychoanalysis, psychopathology and psychiatry in an ill-defined way. For instance, affective-cognitive structures like "life space" or "object representations" can be seen as products of mental processing. These structures, in turn, modulate dynamics of mental processes. Additionally, we suggest a coupled network concept of emotions and motivations as the main subsystem that modulates mental dynamics that results in a qualitative systemic model of the mind. Finally, we assume that a revisited systemic approach could improve interdisciplinary understanding of the mental.
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Affiliation(s)
- Felix Tretter
- Bertalanffy Center for the Study of Systems Science, Vienna, Austria
| | - Henriette Löffler-Stastka
- Department of Psychoanalysis and Psychotherapy, and Teaching Center, Medical University of Vienna, Vienna, Austria
- *Correspondence: Henriette Löffler-Stastka,
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Ammerman BA, Steinberg L, McCloskey MS. Risk-Taking Behavior and Suicidality: The Unique Role of Adolescent Drug Use. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2018; 47:131-141. [PMID: 27732082 PMCID: PMC6082017 DOI: 10.1080/15374416.2016.1220313] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Research has supported an association between suicidal thoughts/behaviors and risk taking, which may be particularly strong during adolescence when risk taking is known to increase. However, extant research has focused on individual risk-taking behaviors (e.g., alcohol use), limiting our ability to evaluate the unique association between different risk-taking behaviors and suicidal thoughts/behaviors. The current study aimed to fill this gap by examining the simultaneous influence of multiple risk-taking behaviors (i.e., risky sexual behavior, tobacco/alcohol use, illicit drug use, delinquent behavior, violent behavior) on adolescent suicidal thoughts/behaviors. Data from the National Longitudinal Study of Adolescent Health was utilized. The sample consisted of 4,834 adolescents who completed home interviews at two time points. At the first time point, participants' mean age was 15.15, with 48% (n = 2,315) identifying as male. Participants provided information about suicidal thoughts/behaviors and multiple risk-taking behaviors at an initial interview and at a second interview, approximately 11 months later. When independently examined, nearly all assessed risk-taking behaviors were independently associated with suicidal ideation concurrently and prospectively, and with suicide attempts concurrently. When all risk-taking behaviors were examined simultaneously, illicit drug use was the only significant concurrent and significant prospective, albeit negative, predictor of suicidal thoughts and only concurrent predictor of suicidal behavior. The current findings suggest that illicit drug use may have a stronger association with suicidal thoughts and behaviors than other risk-taking behavior. These findings have implications for prevention and intervention programs for adolescents.
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Alexander AC, Ward KD. Understanding Postdisaster Substance Use and Psychological Distress Using Concepts from the Self-Medication Hypothesis and Social Cognitive Theory. J Psychoactive Drugs 2017; 50:177-186. [PMID: 29125424 DOI: 10.1080/02791072.2017.1397304] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article applies constructs from the Self-Medication Hypothesis and Social Cognitive Theory to explain the development of substance use and psychological distress after a disaster. A conceptual model is proposed, which employs a sequential mediation model, identifying perceived coping self-efficacy, psychological distress, and self-medication as pathways to substance use after a disaster. Disaster exposure decreases perceived coping self-efficacy, which, in turn, increases psychological distress and subsequently increases perceptions of self-medication in vulnerable individuals. These mechanisms lead to an increase in postdisaster substance use. Last, recommendations are offered to encourage disaster researchers to test more complex models in studies on postdisaster psychological distress and substance use.
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Affiliation(s)
- Adam C Alexander
- a Graduate Assistant, Division of Social and Behavioral Sciences, School of Public Health , University of Memphis , Memphis , TN , USA
| | - Kenneth D Ward
- b Professor, Division of Social and Behavioral Sciences, School of Public Health , University of Memphis , Memphis , TN , USA
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Park S, Kim J. Latent class analysis of substance use and predictors of latent class membership among adolescents in the Republic of Korea. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1333162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sunhee Park
- College of Nursing Science, East-West Nursing Research Institute, Kyung Hee University, Seoul, Republic of Korea
| | - Junghee Kim
- Department of Nursing, Graduate School, Kyung Hee University, Seoul, Republic of Korea
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47
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Iszáj F, Griffiths MD, Demetrovics Z. Creativity and Psychoactive Substance Use: A Systematic Review. Int J Ment Health Addict 2016. [DOI: 10.1007/s11469-016-9709-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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48
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Fein G. Commentary on Maurage et al.: Theory of Mind Difficulties in Patients with Alcohol Dependence. Alcohol Clin Exp Res 2015; 39:1118-9. [PMID: 26010429 DOI: 10.1111/acer.12761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/23/2015] [Indexed: 11/29/2022]
Affiliation(s)
- George Fein
- Neurobehavioral Research Inc., Kihei, Hawaii.,Medicine and Affiliated Graduate Faculty in Psychology, University of Hawaii, Honolulu, Hawaii
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Siegel JP. Emotional Regulation in Adolescent Substance Use Disorders: Rethinking Risk. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2014. [DOI: 10.1080/1067828x.2012.761169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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50
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Punzi EH, Tidefors I. “It Wasn't the Proper Me” — Narratives about Alcoholism and View of Oneself: The Impact of Disavowed Shortcomings and Dissociation. ALCOHOLISM TREATMENT QUARTERLY 2014. [DOI: 10.1080/07347324.2014.949110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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