1
|
Zvolensky MJ, Clausen BK, Shepherd JM, Redmond BY, Robison JH, Santiago-Torres M, Bricker JB. Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states. Addict Behav 2024; 152:107959. [PMID: 38309241 PMCID: PMC11195297 DOI: 10.1016/j.addbeh.2024.107959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/08/2024] [Accepted: 01/17/2024] [Indexed: 02/05/2024]
Abstract
Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center; HEALTH Institute, University of Houston.
| | | | | | | | | | | | - Jonathan B Bricker
- Fred Hutchinson Cancer Center, Division of Public Health Sciences; Department of Psychology, University of Washington
| |
Collapse
|
2
|
Mayorga NA, Shepherd JM, Garey L, Viana AG, Zvolensky MJ. Heart-Focused Anxiety Among Trauma-Exposed Latinx Young Adults: Relations to General Depression, Suicidality, Anxious Arousal, and Social Anxiety. J Racial Ethn Health Disparities 2022; 9:1135-1144. [PMID: 33977507 PMCID: PMC10027393 DOI: 10.1007/s40615-021-01054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/12/2021] [Accepted: 05/03/2021] [Indexed: 11/27/2022]
Abstract
Rates of traumatic event exposure, posttraumatic stress (PTS), and co-occurring mental health symptoms and disorders are conditionally higher among Latinx individuals compared to other racial/ethnic populations. Importantly, Latinx persons are a heterogeneous population, and certain subgroups endorse higher rates of negative mental health outcomes than others, including Latinx young adults born in the USA. Yet, there is little understanding of individual difference factors among trauma-exposed US born Latinx young adults that may be involved in mental health burden among this group. The present investigation sought to evaluate the potential explanatory relevance of heart-focused anxiety as an individual difference factor regarding some of the most common co-occurring mental health problems among trauma-exposed populations. Specifically, we tested whether heart-focused anxiety was related to increased co-occurring anxious arousal symptoms, depression, social anxiety, and suicidality among 169 (84% female, Mage=23.15 years, SD=6.07) trauma-exposed Latinx young adults. Results indicated that heart-focused anxiety was a statistically significant predictor of general depression (ΔR2 = .02, F(1, 161) = 4.25, p = .041), suicidality (ΔR2 = .10, F(1, 161) = 21.49, p < .001), anxious arousal (ΔR2 = .11, F(1, 161) = 27.31, p < .001), and social anxiety (ΔR2 = .03, F(1, 161) = 7.93, p = .005). Overall, this work offers empirical evidence that individual differences in heart-focused anxiety are related to more severe co-occurring anxiety and depressive symptomatology among a particularly at risk Latinx segment of the Latinx population (non-immigrant Latinx young adults s with previous trauma history).
Collapse
Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Justin M Shepherd
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- HEALTH Institute, University of Houston, Houston, TX, USA.
| |
Collapse
|
3
|
Mayorga NA, Brooks JR, Walker RL, Garey L, Cardoso JB, Garza M, Ochoa-Perez M, Lemaire C, Viana A, Zvolensky MJ. Evaluating the Role of Anxiety Sensitivity on Behavioral Health Outcomes among Latinx Persons. COGNITIVE THERAPY AND RESEARCH 2022; 46:31-42. [PMID: 37800123 PMCID: PMC10552789 DOI: 10.1007/s10608-021-10239-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 11/24/2022]
Abstract
Background Mexican Americans represent the largest subpopulation among Latinx persons and experience numerous health inequalities for psychological symptoms and behavioral health problems. First generation Mexican Americans are particularly vulnerable to such disparities and past work suggests that the experience of acculturative stress may play a vital role in terms of mental and physical health problems among this population. The current study sought to bridge past work on acculturative stress among first-generation Mexican Americans by exploring the role of anxiety sensitivity (AS; fear of the negative consequences of internal sensations) as a potential mediational factor in terms of psychological and behavioral health problems among this group. Methods The current study consisted of 369 first generation Mexican American persons (86.2% female, 40.1 years of age (SD = 11.1) years in the U.S. attending a Federally Qualified Healthcare Center located in an urban southwestern community. We explored whether AS served as a mediator between acculturative stress and some of the most common and disabling clinical problems among this group, including social anxiety, anxious arousal, general depression, insomnia and pain intensity and disability. Result Consistent with prediction, there was a statistically significant indirect effect of acculturative stress via AS across all criterion variables apart from pain intensity (depression [ab = - 0.17, SE = 0.05, 95% CI [0.08, 0.26]], insomnia [ab = 0.07, SE = 0.02, 95% CI [0.03, 0.10]], social anxiety [ab 0.05, SE = 0.02, 95% CI [0.02, 0.08]], anxious arousal [ab = 0.08, SE = 0.03, 95% CI [0.03, 0.12]], pain disability [ab = 0.05, SE = 0.02, 95% CI [0.02, 0.09]]). Comparative models were run to evaluate the specificity of hypothesized statistically significant models. For all models except anxious arousal and general depression, the alternative model was rejected, adding support to the hypothesized pathway. Conclusion Overall, this work provides initial support for the role of AS in terms of the relation between acculturative stress and numerous psychological and behavioral health problems among Mexican American adults in a clinical setting.
Collapse
Affiliation(s)
- Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Jasmin R. Brooks
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Rheeda L. Walker
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | | | | | - Andres Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J. Zvolensky
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
| |
Collapse
|
4
|
Cunradi CB, Caetano R, Ponicki WR, Alter HJ. Interrelationships of Economic Stressors, Mental Health Problems, Substance Use, and Intimate Partner Violence among Hispanic Emergency Department Patients: The Role of Language-Based Acculturation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12230. [PMID: 34831985 PMCID: PMC8623040 DOI: 10.3390/ijerph182212230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022]
Abstract
We analyzed the interrelationships of economic stressors, mental health problems, substance use, and intimate partner violence (IPV) among a sample of Hispanic emergency department patients and probed if Spanish language preference, which may represent low acculturation and/or immigrant status, had a protective effect, in accordance with the Hispanic health paradox. Study participants (n = 520; 50% female; 71% Spanish speakers) provided cross-sectional survey data. Gender-stratified logistic regression models were estimated for mental health problems (PTSD, anxiety, depression), substance use (risky drinking, cannabis, illicit drug use), and IPV. Results showed that economic stressors were linked with mental health problems among men and women. Among men, PTSD was associated with greater odds of cannabis and illicit drug use. Men who used cannabis and illicit drugs were more likely to report IPV. Male Spanish speakers had lower odds of anxiety and cannabis use than English speakers. Female Spanish speakers had lower odds of substance use and IPV than English speakers. The protective effect of Spanish language preference on some mental health, substance use, and IPV outcomes was more pronounced among women. Future research should identify the mechanisms that underlie the protective effect of Spanish language preference and explore factors that contribute to the observed gender differences.
Collapse
Affiliation(s)
- Carol B. Cunradi
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (R.C.); (W.R.P.)
| | - Raul Caetano
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (R.C.); (W.R.P.)
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2150 Shattuck Avenue, Suite 601, Berkeley, CA 94704, USA; (R.C.); (W.R.P.)
| | - Harrison J. Alter
- Andrew Levitt Center for Social Emergency Medicine, Oakland, CA 94602, USA;
| |
Collapse
|
5
|
Lee CS, O'Connor BM, Todorova I, Nicholls ME, Colby SM. Structural racism and reflections from Latinx heavy drinkers: Impact on mental health and alcohol use. J Subst Abuse Treat 2021; 127:108352. [PMID: 34134869 DOI: 10.1016/j.jsat.2021.108352] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/12/2020] [Accepted: 02/24/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Discrimination and social inequity increase risk for alcohol use disorders among Latinxs. An alcohol intervention trial that led to significant reductions in alcohol-related consequences also produced significant reductions in mental health symptoms for Latinx heavy drinkers. In the current qualitative study, we explore this trial's mental health effect by examining participants' perspectives on the social context of immigration, i.e., structural barriers, and associations among the immigrant experience, stigma, depressive/anxiety symptomatology, and alcohol consumption. METHODS Study participants were eligible if they completed the clinical trial, exhibited levels of depressive and anxiety symptoms that exceeded the range for clinical depression (≥18, CES-D) and anxiety (≥12, BAI) at baseline, and demonstrated significant declines in depression and anxiety symptoms 12 months following their completion of the trial. The study coded 24 participant transcripts using ATLAS.ti and thematic analysis. RESULTS Participants reported their responses to structural barriers (e.g., a lack of educational supports, difficulties accessing safety net programs). Reported experiences of exclusion and discrimination were associated with depressive and anxiety symptoms. Stigmatization processes included feeling isolated and contributed to poor mental health. Participants reported drinking to cope with low mood. CONCLUSIONS Structural barriers are exclusionary because they limit full participation and communicate who does/does not belong along race/ethnic lines, i.e., structural racism. Feeling stigmatized for being different was associated with feelings of anxiety and depression among our immigrant participants. Future interventions must focus on stressors associated with the constraints of being an immigrant. Understanding how structural barriers and structural racism impact health behavior can enrich the design and impact of interventions for socially disadvantaged Latinx individuals.
Collapse
Affiliation(s)
- Christina S Lee
- Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, USA.
| | | | - Irina Todorova
- Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA.
| | - Mariana E Nicholls
- Department of Applied Psychology, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
| | - Suzanne M Colby
- Department of Psychiatry & Human Behavior, Center for Alcohol & Addiction Studies, Alpert Medical School of Brown University, 121 South Main St., Providence, RI 02912, USA
| |
Collapse
|
6
|
Halsall J, Cooper M. Helpful and unhelpful processes in psychological therapy for female substance users: an interpretative phenomenological analysis. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2020. [DOI: 10.1080/03069885.2020.1861428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Jane Halsall
- Department of Psychology, University of Roehampton, London, UK
| | - Mick Cooper
- Department of Psychology, University of Roehampton, London, UK
| |
Collapse
|
7
|
Khosravani V, Sharifi Bastan F, Kolubinski DC, Amirinezhad A, Ghorbani F. Distress tolerance and special alcohol metacognitions behave differently in the association of negative affect with alcohol-related patterns in men with problematic alcohol use in the abstinence phase. Clin Psychol Psychother 2020; 28:345-354. [PMID: 32896028 DOI: 10.1002/cpp.2514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/29/2022]
Abstract
Negative affect may be related to alcohol-related patterns (e.g., craving and problematic alcohol use). Distress intolerance and positive and negative alcohol-related metacognitions may be underlying mechanisms in this link. This study aimed to evaluate the effect of negative affect including depressive, anxious, and stress symptoms on alcohol craving and problematic alcohol use via the paths of distress tolerance and both positive and negative alcohol-related metacognitions. Three hundred men with problematic alcohol use during the abstinence phase completed psychological and clinical measures. Results showed that craving and negative alcohol metacognitions mediated the relationship between negative affect and problematic alcohol use. Negative affect had a direct and positive effect on craving and indirect effect via distress intolerance and positive alcohol metacognitions. In turn, distress intolerance and positive alcohol metacognitions indirectly and positively affected problematic alcohol use via craving. The study indicates that distress tolerance and distinct alcohol metacognitions may be differently related to various patterns of alcohol-related problems, such that alcohol drinkers with high levels of negative affect, distress intolerance, and positive alcohol metacognitions show higher levels of craving, while high negative affect in relation to high negative alcohol metacognitions and alcohol craving is related to the perpetuation of alcohol use or problematic alcohol use.
Collapse
Affiliation(s)
- Vahid Khosravani
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | | | | | - Ali Amirinezhad
- Psychosocial Injuries Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Fatemeh Ghorbani
- Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
8
|
Ünübol H, Sayar GH. Substance use and its risk factors in Turkey: a nationally representative sample study. J Ethn Subst Abuse 2020; 21:476-498. [DOI: 10.1080/15332640.2020.1781731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
9
|
Yang K, Yang Q, Niu Y, Fan F, Chen S, Luo X, Tan S, Wang Z, Tong J, Yang F, Le TM, Li CSR, Tan Y. Cortical Thickness in Alcohol Dependent Patients With Apathy. Front Psychiatry 2020; 11:364. [PMID: 32431630 PMCID: PMC7214693 DOI: 10.3389/fpsyt.2020.00364] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/14/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Many studies reported structural brain changes in patients with alcohol dependence (PADs). However, no studies identified structural correlates of apathy that might aggravate alcohol misuse. Here, we explored regional differences in cortical thickness in PADs relative to healthy controls (HCs), and examined the potential correlation of regional thickness with the severity of apathy. METHODS Magnetic resonance imaging data were collected from 33 male PADs and 35 male age- and education-matched HCs. We used the FreeSurfer software to investigate group differences in cortical thickness across 148 regions. Apathy was evaluated using the Lille Apathy Rating Scale-Informant (LARS-I). Regression analyses examined the relationship between cortical thickness of regions of interest and apathy score in PADs. RESULTS Compared to HCs, PADs showed significant decreases in the cortical thickness of occipito-temporal cortex (OTC), including the left middle occipital gyrus and occipital pole, right superior occipital gyri, and bilateral lingual gyrus; bilateral superior parietal cortex (SPC), including the right intraparietal sulcus; and bilateral inferior parietal cortex (IPC). Furthermore, the cortical thickness of all of the three regions was negatively correlated with the apathy total scores. The cortical thickness of the IPC was also negatively correlated with the action initiation subscore of the LARS-I. CONCLUSIONS The current results suggest the thickness of bilateral parietal and occipital temporal cortices as neural markers of apathy in PADs. These findings add to the literature by identifying the neural bases of a critical clinical feature of individuals with alcoholism.
Collapse
Affiliation(s)
- Kebing Yang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Qingyan Yang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Yajuan Niu
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Fengmei Fan
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Song Chen
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Shuping Tan
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Zhiren Wang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Jinghui Tong
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Fude Yang
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Thang M. Le
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
| | - Chiang-Shan R. Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT, United States
| | - Yunlong Tan
- Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| |
Collapse
|
10
|
Paulus DJ, Zvolensky MJ. The prevalence and impact of elevated anxiety sensitivity among hazardous drinking college students. Drug Alcohol Depend 2020; 209:107922. [PMID: 32088590 PMCID: PMC7536785 DOI: 10.1016/j.drugalcdep.2020.107922] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/15/2020] [Accepted: 02/12/2020] [Indexed: 02/03/2023]
Abstract
Hazardous drinking is prevalent among college students, yet few seek treatment. Anxiety sensitivity AS is one factor with relevance to drinking. Yet, there are no known estimates of the prevalence of elevated AS among hazardous drinkers. The current study sought to estimate the prevalence of elevated AS among hazardous drinking college students and to examine relations between AS and hazardous drinking. Data from 1257 students Mage = 22.08; 80.4 % female; 76.8 % racial/ethnic minorities was employed. Approximately one third (30.7 %) of the sample met criteria for hazardous drinking. Among hazardous drinkers, 77.5 % had clinically elevated AS; similar rates were evidenced across sex and race/ethnicity. Hazardous drinkers reported significantly greater AS scores than moderate drinkers and non-drinkers (p < 0.001; η2 = 0.09). Those with elevated AS were more than three times more likely to be hazardous drinkers (p < 0.001). Among hazardous drinkers, those with elevated AS had more severe drinking levels (p < 0.001; Cohen's d=0.07) as well as greater likelihood, number, and disturbance related to use of other substances (p's from <0.001-0.005; Cohen's d's from 0.01 to 0.02). Findings from this study suggest that most hazardous drinkers have elevated AS, and that elevated AS is associated with a substantially higher likelihood of being a hazardous drinker. Hazardous drinkers with elevated AS report more severe drinking and other substance use than those with normative AS. There may be practical clinical benefit of implementing focus on AS to reduce hazardous drinking in college settings.
Collapse
Affiliation(s)
- Daniel J. Paulus
- Medical University of South Carolina, Department of Neuroscience, Charlestion, SC 29403
- University of Houston, Department of Psychology, Houston, TX, 77204
| | - Michael J. Zvolensky
- University of Houston, Department of Psychology, Houston, TX, 77204
- The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX 77030
- Health Institute, University of Houston, Houston, TX 77204
| |
Collapse
|
11
|
Bakhshaie J, Rogers AH, Kauffman BY, Tran N, Buckner JD, Ditre JW, Zvolensky MJ. Emotion dysregulation as an explanatory factor in the relation between negative affectivity and non-medical use of opioid in a diverse young adult sample. Addict Behav 2019; 95:103-109. [PMID: 30877901 DOI: 10.1016/j.addbeh.2019.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 01/31/2019] [Accepted: 02/28/2019] [Indexed: 02/03/2023]
Abstract
The non-medical use of prescription opioids is an area of increasing public health concern, particularly among young college-age adults (ages 18-25) who demonstrate an increased risk of opioid-related problems. Negative mood states are consistently associated with more severe non-medical use of opioid. Emotion dysregulation defined an impaired ability to understand, evaluate, and differentiate one's emotions, and access strategies to regulate them could play an explanatory role in this association. The present study examined the potential explanatory role of emotion dysregulation in the relationship between negative affectivity and non-medical use of prescription opioid among a racially/ethnically diverse young adult sample (N = 2080, 78.7% female, Mage = 21.9, SD = 4.9) attending a large southwestern state university, and across the two sub-samples of individuals with and without pain. Results indicated that emotion dysregulation explained, in part, the association between negative affectivity and non-medical use of opioid-related variables, including self-reported addiction to opioids, denial of opioid prescription by a healthcare provider, and family concerns about participant's opioid use. These indirect effects were comparable across individuals with and without pain. Findings suggest that targeting emotion dysregulation may be one therapeutic strategy to reduce non-medical use of opioid in the context of negative affectivity among college students.
Collapse
|
12
|
Evren C, Karabulut V, Alniak I, Evren B, Carkci OH, Yilmaz Cengel H, Ozkara Menekseoglu P, Cetin T, Bozkurt M, Umut G. Emotion dysregulation and internalizing symptoms affect relationships between ADHD symptoms and borderline personality features among male patients with substance use disorders. PSYCHIAT CLIN PSYCH 2019. [DOI: 10.1080/24750573.2019.1595271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Cuneyt Evren
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Vahap Karabulut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Izgi Alniak
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Bilge Evren
- Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey
| | - Ozlem Helin Carkci
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Hanife Yilmaz Cengel
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Pelin Ozkara Menekseoglu
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Turan Cetin
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Muge Bozkurt
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - Gokhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| |
Collapse
|
13
|
Burton CL, Wang K, Pachankis JE. Does getting stigma under the skin make it thinner? Emotion regulation as a stress-contingent mediator of stigma and mental health. Clin Psychol Sci 2018; 6:590-600. [PMID: 30221083 PMCID: PMC6133258 DOI: 10.1177/2167702618755321] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Emotion regulation deficits may link stigma to poor mental health, yet existing studies rely on self-reported stigma and do not consider contextual factors. In the present research, we examined associations among cultural stigma (i.e., objective devaluation of others' status), emotion regulation deficits, and poor mental health. In Study 1, we created an index of cultural stigma by asking members of the general public and stigma experts to indicate desired social distance towards 93 stigmatized attributes. In Study 2, emotion regulation deficits mediated the association between cultural stigma and adverse mental health outcomes, including depressive symptoms and alcohol use problems, among individuals endorsing diverse stigmatized identities. The indirect effect of cultural stigma, via emotion regulation, on these outcomes was stronger among those reporting more life stress. These findings highlight the adverse impact of cultural stigma on mental health and its role in potentiating stigmatized individuals' susceptibility to general life stress.
Collapse
Affiliation(s)
| | - Katie Wang
- Department of Social and Behavioral Sciences, Yale School of Public Health
| | - John E Pachankis
- Department of Social and Behavioral Sciences, Yale School of Public Health
| |
Collapse
|
14
|
Wang K, Burton CL, Pachankis JE. Depression and Substance Use: Towards the Development of an Emotion Regulation Model of Stigma Coping. Subst Use Misuse 2018; 53:859-866. [PMID: 29125383 PMCID: PMC5884706 DOI: 10.1080/10826084.2017.1391011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The comorbidity between depression and substance use problems is well-documented, yet little research has investigated how stigma associated with one's depression might relate to alcohol and drug use. The current study examined the association between depression-related stigma and substance use coping and considered the role of emotion dysregulation (i.e., difficulty in monitoring, evaluating, and modulating one's emotional reactions) as a mechanism underlying this association. A sample of individuals who self-identified as having current or remitted depression (N = 218) completed self-report measures of depression-related stigma, emotion dysregulation, and tendency to rely on alcohol or drugs to cope with psychological distress. Depression-related stigma was positively associated with emotion dysregulation, which was in turn associated with a greater tendency to engage in substance use coping. These findings provide initial support for the role of stigma as a contributor to maladaptive coping responses, such as substance use, among people living with depression. Further, they underscored the potential utility of targeting emotion dysregulation in stigma coping and substance abuse prevention intervention efforts.
Collapse
Affiliation(s)
- Katie Wang
- a Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, School of Public Health , Yale University , New Haven , Connecticut , USA
| | - Charles L Burton
- b Center for Interdisciplinary Research on AIDS , Yale University , New Haven , Connecticut , USA
| | - John E Pachankis
- a Department of Chronic Disease Epidemiology, Social and Behavioral Sciences Division, School of Public Health , Yale University , New Haven , Connecticut , USA
| |
Collapse
|
15
|
Kauffman BY, Farris SG, Alfano CA, Zvolensky MJ. Emotion dysregulation explains the relation between insomnia symptoms and negative reinforcement smoking cognitions among daily smokers. Addict Behav 2017; 72:33-40. [PMID: 28359971 PMCID: PMC5863731 DOI: 10.1016/j.addbeh.2017.03.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 02/09/2017] [Accepted: 03/10/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Insomnia co-occurs with smoking. However, mechanisms that may explain their comorbidity are not well known. METHOD The present study tested the hypothesis that insomnia would exert an indirect effect on negative reinforcement smoking processes via emotion dysregulation among 126 adult non-treatment seeking daily smokers (55 females; Mage=44.1years, SD=9.72). Negative reinforcement smoking processes included negative reinforcement smoking outcome expectancies, negative reinforcement smoking motives, and two negative expectancies from brief smoking abstinence (somatic symptoms and harmful consequences). RESULTS Insomnia symptoms yielded a significant indirect effect through emotion dysregulation for negative reinforcement smoking outcome expectancies, negative reinforcement smoking motives, and harmful consequences expectancies from brief smoking abstinence. In contrast to prediction, however, insomnia was not associated with somatic symptom expectancies from brief smoking abstinence through emotion dysregulation. CONCLUSIONS These data may suggest that the indirect effect of emotion dysregulation is more relevant to cognitive-affective negative reinforcement processes rather than somatic states. Overall, the present findings contribute to a growing body of literature linking emotion dysregulation as an explanatory mechanism for insomnia and smoking and uniquely extend such work to an array of clinically significant negative reinforcement smoking processes.
Collapse
Affiliation(s)
- Brooke Y Kauffman
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Samantha G Farris
- University of Houston, Department of Psychology, Houston, TX, United States; Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, United States
| | - Candice A Alfano
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
| |
Collapse
|
16
|
Paulus DJ, Viana AG, Ditre JW, Bakhshaie J, Garza M, Berger Cardoso J, Valdivieso J, Ochoa-Perez M, Lemaire C, Zvolensky MJ. Synergistic effects of pain and alcohol use in relation to depressive and anxiety symptoms among Latinos in primary care. Cogn Behav Ther 2017; 46:478-492. [DOI: 10.1080/16506073.2017.1336185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Daniel J. Paulus
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G. Viana
- Department of Psychology, University of Houston, Houston, TX, USA
- Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX, USA
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jafar Bakhshaie
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Monica Garza
- Legacy Community Health Services, Houston, TX, USA
| | | | | | | | - Chad Lemaire
- Legacy Community Health Services, Houston, TX, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
17
|
Paulus DJ, Gallagher MW, Rogers AH, Viana AG, Garza M, Valdivieso J, Ochoa-Perez M, Lemaire C, Bakhshaie J, Zvolensky MJ. Emotion dysregulation as a mechanism linking anxiety and hazardous drinking among Latinos in primary care. Am J Addict 2017; 26:615-622. [DOI: 10.1111/ajad.12574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/29/2017] [Accepted: 05/13/2017] [Indexed: 12/30/2022] Open
Affiliation(s)
| | - Matthew W. Gallagher
- Department of Psychology; University of Houston; Houston Texas
- University of Houston; Texas Institute for Measurement, Evaluation, and Statistics; Houston Texas
| | | | - Andres G. Viana
- Department of Psychology; University of Houston; Houston Texas
- University of Houston; Texas Institute for Measurement, Evaluation, and Statistics; Houston Texas
| | | | | | | | | | - Jafar Bakhshaie
- Department of Psychology; University of Houston; Houston Texas
| | - Michael J. Zvolensky
- Department of Psychology; University of Houston; Houston Texas
- Department of Behavioral Science; The University of Texas MD Anderson Cancer Center; Houston Texas
| |
Collapse
|
18
|
Paulus DJ, Valadka J, Businelle MS, Gallagher MW, Viana AG, Schmidt NB, Zvolensky MJ. Emotion dysregulation explains associations between anxiety sensitivity and hazardous drinking and drinking motives among adult treatment-seeking smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:189-199. [PMID: 28080096 DOI: 10.1037/adb0000252] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Smoking and drinking frequently co-occur. For example, alcohol use is associated with smoking lapses during quit attempts. However, little is known regarding psychological factors explaining drinking among smokers. Anxiety sensitivity is a risk factor associated with hazardous drinking and drinking to cope and/or conform, although little is known about mechanisms underlying such associations. One potential explanatory factor is emotion dysregulation. The current study examined emotion dysregulation as an explanatory factor underlying Anxiety Sensitivity and 5 alcohol-related outcomes: hazardous drinking, alcohol consumption, alcohol problems, coping-oriented drinking, and drinking to conform. Participants for this study were 467 treatment-seeking adult, daily smokers (48.2% women; Mage = 36.7 years, SD = 13.6) who reported smoking an average of 16.5 cigarettes per day. Results indicate significant indirect effects of Anxiety Sensitivity on hazardous drinking via emotion dysregulation, alcohol consumption, alcohol problems, drinking to cope, and drinking to conform. Effects were medium in size. Alternative models testing indirect effects of emotion dysregulation through Anxiety Sensitivity on outcomes, and Anxiety Sensitivity through outcomes on emotion dysregulation were nonsignificant and all had small effect sizes. Follow-up tests examined the path of effects from Anxiety Sensitivity through specific emotion-dysregulation subfactors. Thus, among treatment-seeking smokers, emotion dysregulation may explain the associations of Anxiety Sensitivity with alcohol-related outcomes. This pattern of findings highlights the potential importance of interventions targeting emotion dysregulation among hazardous-drinking smokers. (PsycINFO Database Record
Collapse
|
19
|
Anxiety Sensitivity and Alcohol Use Among Acute-Care Psychiatric Inpatients: The Mediating Role of Emotion Regulation Difficulties. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9792-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|