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Collins AC, Lekkas D, Struble CA, Trudeau BM, Jewett AD, Griffin TZ, Nemesure MD, Price GD, Heinz MV, Nepal S, Pillai A, Mackin DM, Campbell AT, Budney AJ, Jacobson NC. From mood to use: Using ecological momentary assessments to examine how anhedonia and depressed mood impact cannabis use in a depressed sample. Psychiatry Res 2024; 339:116110. [PMID: 39079375 DOI: 10.1016/j.psychres.2024.116110] [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: 04/04/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/15/2024]
Abstract
Anhedonia and depressed mood are two cardinal symptoms of major depressive disorder (MDD). Prior work has demonstrated that cannabis consumers often endorse anhedonia and depressed mood, which may contribute to greater cannabis use (CU) over time. However, it is unclear (1) how the unique influence of anhedonia and depressed mood affect CU and (2) how these symptoms predict CU over more proximal periods of time, including the next day or week (rather than proceeding weeks or months). The current study used data collected from ecological momentary assessment (EMA) in a sample with MDD (N = 55) and employed mixed effects models to detect and predict weekly and daily CU from anhedonia and depressed mood over 90 days. Results indicated that anhedonia and depressed mood were significantly associated with CU, yet varied at daily and weekly scales. Moreover, these associations varied in both strength and directionality. In weekly models, less anhedonia and greater depressed mood were associated with greater CU, and directionality of associations were reversed in the models looking at any CU (compared to none). Findings provide evidence that anhedonia and depressed mood demonstrate complex associations with CU and emphasize leveraging EMA-based studies to understand these associations with more fine-grained detail.
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Affiliation(s)
- Amanda C Collins
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States.
| | - Damien Lekkas
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, United States
| | - Cara A Struble
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Brianna M Trudeau
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Abi D Jewett
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Tess Z Griffin
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Matthew D Nemesure
- Digital Data Design Institute, Harvard Business School, Boston, MA, United States
| | - George D Price
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, NH, United States
| | - Michael V Heinz
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Subigya Nepal
- Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Arvind Pillai
- Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Daniel M Mackin
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States
| | - Andrew T Campbell
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Computer Science, Dartmouth College, Hanover, NH, United States
| | - Alan J Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States; Department of Computer Science, Dartmouth College, Hanover, NH, United States
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Douglass AR, Maister A, Moeller KE, Salwan A, Vallabh A, Waters K, Payne GH. Exploring the harm reduction paradigm: the role of Board-Certified Psychiatric Pharmacists. Ment Health Clin 2024; 14:253-266. [PMID: 39104432 PMCID: PMC11298032 DOI: 10.9740/mhc.2024.08.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/07/2024] [Indexed: 08/07/2024] Open
Abstract
Deaths related to opioid overdoses continue to climb, and there remains a need for innovative strategies to address this ongoing crisis. Harm reduction (HR), a nonjudgmental philosophy aimed at reducing consequences associated with drug use and other potentially unsafe behavior, has emerged as a compassionate and effective approach. Harm reduction further emphasizes overdose prevention and fosters a shift in perspective that recognizes substance use disorder as a disease and not a moral failing. The tenets of HR collectively advocate for the well-being of individuals who use substances and support any positive change as defined by the individual. Given the high rate of morbidity and mortality associated with substance misuse and barriers or ambivalence to receiving treatment, awareness of and advocacy for HR practice is essential. This manuscript aims to describe evidence-based HR interventions, provide a foundation for the implementation of services, and further promote the importance of providing humanistic care without judgment. As valued members of the multidisciplinary treatment team, Board-Certified Psychiatric Pharmacists should implement and engage in HR services in the settings where people with substance use disorders receive care.
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Affiliation(s)
- Amber R. Douglass
- (Corresponding author) Clinical Pharmacist Practitioner - Mental Health, VISN 1 Clinical Resource Hub - VA Connecticut Healthcare System, West Haven, Connecticut,
| | - Ashley Maister
- Clinical Pharmacist Practitioner - Mental Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
| | | | - Aaron Salwan
- Clinical Pharmacy Specialist, Behavioral Health, Montefiore Nyack Hospital, Nyack, New York
| | - Anuja Vallabh
- SUD/MH Clinical Pharmacist Practitioner, VISN 12 Clinical Resource Hub - Jesse Brown VA Medical Center, Chicago, Illinois
| | - Kristin Waters
- Assistant Clinical Professor, University of Connecticut, Storrs, Connecticut
| | - Gregory H. Payne
- Director of Strategic Initiatives, American Association of Psychiatric Pharmacists, Lincoln, Nebraska
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Patarroyo-Rodriguez L, Cavalcanti S, Vande Voort JL, Singh B. The Use of Ketamine for the Treatment of Anhedonia in Depression. CNS Drugs 2024; 38:583-596. [PMID: 38910222 DOI: 10.1007/s40263-024-01099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/25/2024]
Abstract
Anhedonia, a complex symptom rooted in deficits across reward processes, is primarily linked to depression and schizophrenia but transcends diagnostic boundaries across various mental disorders. Its presence correlates with poorer clinical outcomes, including an increased risk of suicide and diminished response to treatment. The neurobiological underpinnings of anhedonia remain incompletely understood despite advancements in biomarkers and imaging that contribute to deeper insights. Ketamine, known for its rapid-acting antidepressant properties, appears to possess antianhedonic effects through a mechanism of action not fully elucidated. This effect appears to be independent of its antidepressant properties. Explorations into alternative antianhedonic treatments have been underway, yet lingering questions persist, underscoring the imperative need for ongoing research to advance the field.
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Affiliation(s)
| | - Stefanie Cavalcanti
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jennifer L Vande Voort
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Xiao J, Adkinson JA, Myers J, Allawala AB, Mathura RK, Pirtle V, Najera R, Provenza NR, Bartoli E, Watrous AJ, Oswalt D, Gadot R, Anand A, Shofty B, Mathew SJ, Goodman WK, Pouratian N, Pitkow X, Bijanki KR, Hayden B, Sheth SA. Beta activity in human anterior cingulate cortex mediates reward biases. Nat Commun 2024; 15:5528. [PMID: 39009561 PMCID: PMC11250824 DOI: 10.1038/s41467-024-49600-7] [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: 09/15/2023] [Accepted: 06/07/2024] [Indexed: 07/17/2024] Open
Abstract
The rewards that we get from our choices and actions can have a major influence on our future behavior. Understanding how reward biasing of behavior is implemented in the brain is important for many reasons, including the fact that diminution in reward biasing is a hallmark of clinical depression. We hypothesized that reward biasing is mediated by the anterior cingulate cortex (ACC), a cortical hub region associated with the integration of reward and executive control and with the etiology of depression. To test this hypothesis, we recorded neural activity during a biased judgment task in patients undergoing intracranial monitoring for either epilepsy or major depressive disorder. We found that beta (12-30 Hz) oscillations in the ACC predicted both associated reward and the size of the choice bias, and also tracked reward receipt, thereby predicting bias on future trials. We found reduced magnitude of bias in depressed patients, in whom the beta-specific effects were correspondingly reduced. Our findings suggest that ACC beta oscillations may orchestrate the learning of reward information to guide adaptive choice, and, more broadly, suggest a potential biomarker for anhedonia and point to future development of interventions to enhance reward impact for therapeutic benefit.
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Affiliation(s)
- Jiayang Xiao
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Joshua A Adkinson
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - John Myers
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | | | - Raissa K Mathura
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Victoria Pirtle
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ricardo Najera
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Nicole R Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Eleonora Bartoli
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Andrew J Watrous
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Denise Oswalt
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ron Gadot
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Adrish Anand
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Ben Shofty
- Department of Neurosurgery, University of Utah, Salt Lake City, UT, 84112, USA
| | - Sanjay J Mathew
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Nader Pouratian
- Department of Neurological Surgery, UT Southwestern Medical Center, Dallas, TX, 75390, USA
| | - Xaq Pitkow
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, 77030, USA
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA
- Center for Neuroscience and Artificial Intelligence, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Kelly R Bijanki
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Benjamin Hayden
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, 77030, USA.
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, 77030, USA.
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, 77030, USA.
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, 77005, USA.
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Stamatovich SN, Simons RM, Simons JS. Anhedonia and impulsivity in college alcohol use: A path analysis. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-11. [PMID: 37722885 DOI: 10.1080/07448481.2023.2249116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/09/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE Alcohol use is a substantial problem among college students and has several negative consequences. The current study examined the associations between anhedonia and alcohol use and related problems via impulsive behavior (e.g., negative urgency, sensation seeking). We parsed anhedonia into four specific facets: consummatory, anticipatory, recreational, and social anhedonia. PARTICIPANTS Six hundred and forty college students aged 18-25 were included in the final analysis. METHOD Data were collected via Amazon Mechanical Turk. Self-report inventories assessing for anhedonia, alcohol use, impulsive behavior, and depressed mood were utilized. RESULTS Recreational consummatory anhedonia was negatively associated with alcohol use and alcohol-related problems through negative urgency. Recreational consummatory anhedonia also had significant negative associations with alcohol consumption via sensation seeking. Further, social anticipatory anhedonia was positively associated with alcohol use and related problems via negative urgency. CONCLUSIONS This study highlights important associations between anhedonia, impulsivity, and alcohol use and related problems.
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Affiliation(s)
- Sydney N Stamatovich
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Raluca M Simons
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Jeffrey S Simons
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
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Stull SW, Mogle J, Bertz JW, Burgess-Hull AJ, Panlilio LV, Lanza ST, Preston KL, Epstein DH. Variability in intensively assessed mood: Systematic sources and factor structure in outpatients with opioid use disorder. Psychol Assess 2022; 34:966-977. [PMID: 35980695 PMCID: PMC10066936 DOI: 10.1037/pas0001160] [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] [Indexed: 11/08/2022]
Abstract
In intensive longitudinal studies using ecological momentary assessment, mood is typically assessed by repeatedly obtaining ratings for a large set of adjectives. Summarizing and analyzing these mood data can be problematic because the reliability and factor structure of such measures have rarely been evaluated in this context, which-unlike cross-sectional studies-captures between- and within-person processes. Our study examined how mood ratings (obtained thrice daily for 8 weeks; n = 306, person moments = 39,321) systematically vary and covary in outpatients receiving medication for opioid use disorder (MOUD). We used generalizability theory to quantify several aspects of reliability, and multilevel confirmatory factor analysis (MCFA) to detect factor structures within and across people. Generalizability analyses showed that the largest proportion of systematic variance across mood items was at the person level, followed by the person-by-day interaction and the (comparatively small) person-by-moment interaction for items reflecting low arousal. The best-fitting MCFA model had a three-factor structure both at the between- and within-person levels: positive mood, negative mood, and low-arousal states (with low arousal considered as either a separate factor or a subfactor of negative mood). We conclude that (a) mood varied more between days than between moments and (b) low arousal may be worth scoring and reporting separately from positive and negative mood states, at least in a MOUD population. Our three-factor structure differs from prior analyses of mood; more work is needed to understand the extent to which it generalizes to other populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Samuel W. Stull
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, USA
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
| | - Jacqueline Mogle
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Jeremiah W. Bertz
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
| | - Albert J. Burgess-Hull
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
| | - Leigh V. Panlilio
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
| | - Stephanie T. Lanza
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, 16802, USA
- The Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Kenzie L. Preston
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
| | - David H. Epstein
- Intramural Research Program, National Institute on Drug Abuse, 251 Bayview Blvd., Suite 200, Baltimore, MD, 21224, United States
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