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Singer I, Gagnon M, B. Leclerc J. PROTOCOL: Mindfulness-based interventions for improving tic-related symptoms in children and adults with chronic tic disorder and Tourette's disorder: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1427. [PMID: 39040429 PMCID: PMC11260994 DOI: 10.1002/cl2.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 07/01/2024] [Accepted: 07/08/2024] [Indexed: 07/24/2024]
Abstract
This is a protocol for a Cochrane Review (prototype). The objectives are as follows: This systematic review aims to summarize the available scientific literature on the effect of mindfulness-based approaches in children and adults with Chronic Tic Disorder (CTD) or Tourette Disorder (TD). More specifically, the research question is: What is the effectiveness of mindfulness-based interventions in reducing tic severity and improving overall functioning, quality of life, and co-occurring symptoms in children and adults with CTD or TD?
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Affiliation(s)
- Ilana Singer
- Department of PsychologyUniversité du Québec à MontréalMontrealQuebecCanada
- Centre de recherche du CIUSSS du Nord‐de‐l’île‐de‐MontréalMontrealQuebecCanada
- Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontrealQuebecCanada
| | - Méliza Gagnon
- Department of PsychologyUniversité du Québec à MontréalMontrealQuebecCanada
- Centre de recherche du CIUSSS du Nord‐de‐l’île‐de‐MontréalMontrealQuebecCanada
- Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontrealQuebecCanada
| | - Julie B. Leclerc
- Department of PsychologyUniversité du Québec à MontréalMontrealQuebecCanada
- Centre de recherche du CIUSSS du Nord‐de‐l’île‐de‐MontréalMontrealQuebecCanada
- Centre de recherche de l'Institut universitaire en santé mentale de MontréalMontrealQuebecCanada
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Hatoum AH, Burton AL. Applications and efficacy of radically open dialectical behavior therapy (RO DBT): A systematic review of the literature. J Clin Psychol 2024. [PMID: 39056514 DOI: 10.1002/jclp.23735] [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] [Received: 01/26/2024] [Revised: 04/17/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024]
Abstract
Radically open dialectical behaviour therapy (RO DBT) is a transdiagnostic treatment, originally developed as a variant of dialectical behaviour therapy (DBT), that emerged as a novel treatment approach for those presenting with excessive or maladaptive overcontrol. Despite RO DBT's growing popularity among clinicians as a treatment for chronic depression, personality disorders and eating disorders, to date, no systematic review has been conducted to summarise the evidence on this therapy. Therefore, the aim of this study was to systematically review the literature to provide a current and comprehensive summary of the available evidence on the clinical applications and efficacy of RO DBT. Articles were included if they were original research studies that described the use of RO DBT in the treatment of any psychological disorder, condition or symptom, published in the English language in a peer-reviewed journal. Four electronic databases were searched, and screening, selection, risk of bias assessment and data extraction were all conducted by two independent reviewers. Fourteen articles were included in this review, including two qualitative articles, one case study, five case series studies, four quasi-experimental studies, and two articles describing one randomized control trial. Findings indicated there is emerging evidence for the use of RO DBT in both adolescents and adults, for disorders characterized by excessive self-control, such as anorexia nervosa and autism, as well as for treatment-resistant depression. While RO DBT shows promise as a treatment for disorders of overcontrol, further research is needed. This review outlines current gaps and identifies areas for future research.
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Affiliation(s)
- Amaani H Hatoum
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amy L Burton
- School of Psychology, The University of Sydney, Sydney, New South Wales, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Yalch MM. Dimensional approaches to studying, assessing, and treating traumatic stress: Introduction to the Special Section. J Trauma Stress 2024; 37:357-360. [PMID: 38580619 DOI: 10.1002/jts.23045] [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] [Received: 03/06/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/07/2024]
Abstract
Dimensional models of psychopathology are gaining empirical support and are, thus, increasingly common in research and clinical practice. This is true for traumatic stress studies, although the movement toward dimensional conceptualizations of traumatic stress may be somewhat slower, perhaps due at least in part to how trauma is diagnosed. The purpose of this special section is to collect and showcase cutting-edge basic, applied, and conceptual work on dimensional models of traumatic stress. Its goal is to highlight the utility of such models and to facilitate greater connection between traumatic stress studies and the broader dimensional movement in psychopathology.
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Affiliation(s)
- Matthew M Yalch
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
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Durpoix A, Rolling J, Coutelle R, Lalanne L. Psychotherapies in opioid use disorder: toward a step-care model. J Neural Transm (Vienna) 2024; 131:437-452. [PMID: 37987829 PMCID: PMC11055728 DOI: 10.1007/s00702-023-02720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
Opioid use disorder (OUD) is characterized by a lack of control in opioid use, resulting in psychological distress and deficits in interpersonal and social functioning. OUD is often associated with psychiatric comorbidities that increase the severity of the disorder. The consequences of OUD are dramatic in terms of increased morbi-mortality. Specific medications and psychotherapies are essential tools not only in the treatment of OUD but also in the prevention of suicide and overdoses. In our review, we assess the different types of psychotherapies (counseling, motivational interviewing, contingency management, cognitive-behavioral therapy, and dialectical-behavior therapy) that are delivered to opioid users, either associated or un-associated with OUD medications and/or medications for psychiatric disabilities. We describe the application of these therapies first to adult opioid users and then to adolescents. This work led us to propose a stepped-care model of psychotherapies for OUD which provided information to assist clinicians in decision-making regarding the selection of psychotherapeutic strategies according to patients' OUD severity.
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Affiliation(s)
- Amaury Durpoix
- Addictology Department, Strasbourg University Hospital, 1, place de l'Hôpital, 67091, Strasbourg, France
- Strasbourg University, Faculty of Medicine, Strasbourg, France
| | - Julie Rolling
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- Regional Center for Psychotrauma Great East, Strasbourg, France
- Centre National de la Recherche Scientifique Unité Propre de Recherche 3212 (CNRS UPR 3212), Institute for Cellular and Integrative Neurosciences (INCI), Strasbourg, France
| | - Romain Coutelle
- Psychiatry, Mental Health and Addictology Department, Strasbourg University Hospital, Strasbourg, France
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France
| | - Laurence Lalanne
- Addictology Department, Strasbourg University Hospital, 1, place de l'Hôpital, 67091, Strasbourg, France.
- INSERM U1114, Cognitive Neuropsychology, and Pathophysiology of Schizophrenia, Strasbourg, France.
- Strasbourg University, Faculty of Medicine, Strasbourg, France.
- Fédération de Médecine translationnelle de Strasbourg, Strasbourg, France.
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Dwyer CL, Padula CB. Context matters: Exploring the adaptive nature of self-regulation skills in predicting abstinence among veterans with alcohol use disorder. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:692-702. [PMID: 38551499 DOI: 10.1111/acer.15289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/23/2024] [Accepted: 02/02/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD) is highly prevalent among veterans in the United States. Self-regulation skills (e.g., coping and emotion regulation) are important biopsychosocial factors for preventing relapse. However, how variation in self-regulation skills supports abstinence based on contextual demands is understudied in veterans with AUD. METHODS In a prospective longitudinal design, treatment-seeking veterans (n = 120; 29 females) aged 23-91 with AUD completed the Alcohol Abstinence Self-Efficacy Scale to assess temptation to drink across several high-risk situations (i.e., negative affect, social/positive emotions, physical concerns, and craving/urges) as well as the Brief-COPE and Emotion Regulation Questionnaire to assess self-regulation skills. Abstinence status was assessed at 6 months. T-tests were used to identify self-regulation skills that differed between abstinent and non-abstinent individuals. Multivariate regression with model selection was performed using all possible interactions between each high-risk situation and the self-regulation skills that significantly differed between groups. RESULTS Overall, 33.3% of participants (n = 40; nine females) were abstinent at 6 months. Abstinent individuals reported significantly higher use of suppression (p = 0.015), acceptance (p = 0.005), and planning (p = 0.045). Multivariate regression identified significant interactions between (1) planning and physical concerns (p = 0.010) and (2) acceptance, suppression, and craving/urges (p = 0.007). Greater planning predicted abstinence in participants with higher temptation to drink due to physical concerns (e.g., pain). For individuals with lower temptation to drink due to cravings/urges, simultaneous higher suppression and acceptance increased the likelihood of abstinence. Conversely, for participants with higher cravings, greater acceptance with lower suppression was linked to a higher probability of abstinence. CONCLUSIONS Results suggest that the adaptiveness of self-regulation skills in predicting AUD recovery is dependent on contextual demands and highlight the need for culturally sensitive treatments. Collectively, these findings indicate that further research on coping and regulatory flexibility may be an important avenue for tailoring AUD treatment for veterans.
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Affiliation(s)
- Candice L Dwyer
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Claudia B Padula
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
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Vieira JL, Snaychuk LA, Milicevic J, Hodgins DC, Shead NW, Keough MT, Kim HS. Adverse Childhood Experiences and Problematic Cannabis Use: The Role of Emotion Dysregulation and Affective Impulsivity. CANNABIS (ALBUQUERQUE, N.M.) 2024; 6:111-126. [PMID: 38883277 PMCID: PMC11178067 DOI: 10.26828/cannabis/2023/000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Problematic cannabis use is highly prevalent among postsecondary students. Consequently, there is a need to examine risk factors associated with problematic cannabis use in this population. The present study investigated whether emotion dysregulation mediates the relationship between adverse childhood experiences (ACEs) and problematic cannabis use, and whether affective impulsivity (negative and positive urgency) uniquely moderates this relationship. Participants consisted of current cannabis users (N = 586) recruited from five universities across Canada. Participants completed an online survey containing self-report measures of ACEs, emotion dysregulation, negative and positive urgency, and problematic cannabis use. Among the sample of postsecondary students, 36% (n = 213) met the threshold for problematic cannabis use. Moderated-mediation analyses revealed that ACEs were positively associated with emotion dysregulation and problematic cannabis use. There was also a significant indirect effect of emotion dysregulation on the association between ACEs and problematic cannabis use at moderate and high (but not low) levels of negative urgency, and at moderate and high (but not low) levels of positive urgency. The moderated-mediation models remained significant when controlling for other facets of impulsivity. Results suggest that elevated levels of emotion dysregulation and urgency are important proximal risk factors for problematic cannabis use among postsecondary students with a history of ACEs. While ACEs cannot be modified given their occurrence in the past, interventions that aim to build mindfulness and adaptive emotion regulation skills may be beneficial for reducing the likelihood that these students will engage in impulsive behaviors, such as cannabis use, when experiencing emotional distress.
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Affiliation(s)
- Jenna L Vieira
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Lindsey A Snaychuk
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Jana Milicevic
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - David C Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - N Will Shead
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | | | - Hyoun S Kim
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
- University of Ottawa Institute of Mental Health Research at the Royal, Ottawa, Ontario, Canada
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Daros AR, Guimond TH, Yager C, Palermo EH, Wilks CR, Quilty LC. Feasibility, Acceptability, and Potential Efficacy of a Self-Guided Internet-Delivered Dialectical Behavior Therapy Intervention for Substance Use Disorders: Randomized Controlled Trial. JMIR Ment Health 2024; 11:e50399. [PMID: 38227362 PMCID: PMC10828941 DOI: 10.2196/50399] [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: 08/26/2023] [Revised: 11/02/2023] [Accepted: 11/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND People with alcohol and substance use disorders (SUDs) often have underlying difficulties in regulating emotions. Although dialectical behavioral therapy is effective for SUDs, it is often difficult to access. Self-guided, internet-delivered dialectical behavioral therapy (iDBT) allows for expanded availability, but few studies have rigorously evaluated it in individuals with SUDs. OBJECTIVE This study examines the feasibility, acceptability, and potential efficacy of an iDBT intervention in treatment-seeking adults with SUDs. We hypothesized that iDBT would be feasible, credible, acceptable, and engaging to people with SUDs. We also hypothesized that the immediate versus delayed iDBT group would show comparatively greater improvements and that both groups would show significant improvements over time. METHODS A 12-week, single-blinded, parallel-arm, randomized controlled trial was implemented, with assessments at baseline and at 4 (acute), 8, and 12 weeks (follow-up). A total of 72 community adults aged 18 to 64 years were randomized. The immediate group (n=38) received access to iDBT at baseline, and the delayed group (n=34) received access after 4 weeks. The intervention (Pocket Skills 2.0) was a self-guided iDBT via a website, with immediate access to all content, additional text and email reminders, and additional support meetings as requested. Our primary outcome was substance dependence, with secondary outcomes pertaining to feasibility, clinical outcomes, functional disability, and emotion dysregulation, among other measures. All outcomes were assessed using self-report questionnaires. RESULTS iDBT was perceived as a credible and acceptable treatment. In terms of feasibility, 94% (68/72) of the participants started iDBT, 13% (9/68) were early dropouts, 35% (24/68) used it for the recommended 8 days in the first month, and 50% (34/68) were still active 4 weeks later. On average, the participants used iDBT for 2 hours and 24 minutes across 10 separate days. In the acute period, no greater benefit was found for the immediate group on substance dependence, although we did find lower depression (b=-2.46; P=.02) and anxiety (b=-2.22; P=.02). At follow-up, there were greater benefits in terms of reduced alcohol (b=-2.00; P=.02) and nonalcoholic substance (b=-3.74; P=.01) consumption in the immediate access group. Both groups demonstrated improvements in substance dependence in the acute (b=-1.73; P<.001) and follow-up period (b=-2.09; P<.001). At follow-up, both groups reported reduced depression, anxiety, suicidal behaviors, emotional dysregulation, and functional disability. CONCLUSIONS iDBT is a feasible and acceptable intervention for patients with SUDs, although methods for improving engagement are warranted. Although results did not support efficacy for the primary outcome at 4 weeks, findings support reductions in substance dependence and other mental health concerns at 12 weeks. Notwithstanding the limitations of this study, the results suggest the potential value of iDBT in the treatment of SUDs and other mental health conditions. TRIAL REGISTRATION ClinicalTrials.gov NCT05094440; https://clinicaltrials.gov/show/NCT05094440.
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Affiliation(s)
- Alexander R Daros
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Timothy H Guimond
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Christina Yager
- Addictions Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emma H Palermo
- Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Chelsey R Wilks
- Department of Psychological Science, University of Missouri-St Louis, St. Louis, MO, United States
| | - Lena C Quilty
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Felix CB, Sand P. Feasibility and Efficacy of Intensive Dialectical Behavior Therapy Skills Training in An Outpatient Setting for A Group of Patients with Extensive Care Needs - A Transdiagnostic Approach. Psychiatr Q 2023; 94:691-704. [PMID: 37792150 PMCID: PMC10638174 DOI: 10.1007/s11126-023-10052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Dialectical behavior therapy (DBT) is a treatment originally developed för chronically suicidal adults. It is common to adapt it by using one specific component, the DBT skills training (DBT-ST) and apply it in a group therapy setting for a variety of mental disorders. The primary aim of the study was to explore whether patients with extended care needs would report improved mental health after participating in an intensive form of DBT-ST. The secondary aim was to explore whether the use of psychiatric inpatient care for the group would decrease. METHODS Thirty-seven participants completed the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), and visual analogue scale (VAS) at three time points: pre-intervention, post-intervention and at 6-month follow-up after intensive DBT-ST. RESULTS One-way ANOVA showed a significant effect for time on the CORE-OM: F (2,35) = 7.93, p = .001, η2 = 0.312 (large effect size). Post hoc tests indicated a significant difference between pre-intervention and post-intervention (p = .001) and between pre-intervention and follow-up (p = .01). A Friedman test indicated a statistically significant difference in the VAS scale scores across the three time points, with p-values between 0.00 and 0.05. There was no difference in psychiatric healthcare consumption. CONCLUSION These study results confirm to some extent the feasibility and effectiveness of the intensive DBT-ST in a transdiagnostic clinical setting. The participants had a positive outcome from the skills training program, but psychiatric healthcare consumption did not decrease.
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Affiliation(s)
- Christina Bertholds Felix
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Sand
- Department of Psychiatry for Affective Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden.
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Ellis JD, Rabinowitz JA, Strickland JC, Skandan N, Hobelmann JG, Finan PH, Huhn AS. Latent patterns of sleep disturbance, pain impact, and depressive symptoms in residential substance use treatment. Drug Alcohol Depend 2023; 248:109903. [PMID: 37182354 PMCID: PMC10330676 DOI: 10.1016/j.drugalcdep.2023.109903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/16/2023]
Abstract
AIM Sleep disturbance, clinically significant pain, and depressive symptoms commonly occur together among individuals with substance use disorders. The purposes of the present study were to 1) identify subgroups of individuals with heterogenous patterns of pain, sleep disturbance, and depressive symptoms, and 2) identify demographic and clinical correlates of profile membership. MATERIAL AND METHODS The present study assessed a sample (N = 8621) of individuals seeking residential substance use treatment in 2020 and 2021 in the United States. We examined whether unique sub-groups could be identified based on patterns of sleep disturbance, pain impact, and depressive symptoms during the first four weeks of treatment, using longitudinal latent profile analysis. Next, we explored demographic, substance use, and clinical correlates (i.e., distress intolerance) of profile membership, as well as whether profile membership was associated with treatment attrition. RESULTS The identified classes were: 1) Low sleep disturbance, pain impact, and depressive symptoms, 2) High pain, remitting depressive symptoms, and mild sleep disturbance, 3) High depressive symptoms, low pain, and remitting sleep disturbance, and 4) High sleep disturbance, pain impact, and depressive symptoms. Individuals with high pain, depressive symptoms, and sleep disturbance were more likely to be older, use opioids as their primary substance, have high distress intolerance, and discontinue treatment. CONCLUSION Results highlight the importance of comprehensive care and management of physical health conditions, particularly among older adults. Further, results highlight that distress intolerance may be a modifiable risk factor for co-occurring sleep disturbance, pain impact, and depressive symptoms.
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Affiliation(s)
- Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jill A Rabinowitz
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Neha Skandan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - J Gregory Hobelmann
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Ashley Addiction Treatment, Havre de Grace, MD, United States
| | - Patrick H Finan
- Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Ashley Addiction Treatment, Havre de Grace, MD, United States.
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Schnell T, Grömm CM, Klöckner N. Predictive impact of different acute cannabis intoxication effects with regard to abstinence motivation and cessation of use. Sci Rep 2023; 13:709. [PMID: 36639397 PMCID: PMC9839715 DOI: 10.1038/s41598-023-27592-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/04/2023] [Indexed: 01/15/2023] Open
Abstract
Cannabis use is a common risk factor for psychoses. But although prevalence of consumption as well as potency of cannabis increased, the incidence of schizophrenia remained stable. The discontinuation hypothesis suggests that a potential increase of psychoses incidence may be relativized by more frequent cessation of consumption due to higher rates of adverse psychosis-like intoxication effects (PLE), caused by stronger cannabis. A mixed methods online survey was administered to 441 current and past users to analyze the predictive impact of different acute intoxication effects regarding abstinence motivation/cessation of use. Our hypothesis was that PLE would be experienced as the most aversive intoxication effect and therefore have the highest predictive significance. Possible confounds were included (craving, patterns of consumption and sociodemographics). Further analyzes compared past versus current users regarding the quality of intoxication effects, suggesting that past users retrospectively experienced more unpleasant experiences than current users. Free-text data explored subjective reasons for abstinence. We found that paranoid/dysphoric intoxication effects were most predictive for abstinence motivation. Less predictive were psychosis-like intoxication effects such as hallucinations. Group comparisons revealed significant more unpleasurable and less positive intoxication effects in past users compared with current users. Current users with the intention to stop consumption showed significantly more paranoia/dysphoria intoxication compared to users with no intention to stop use. As a conclusion, different intoxication experiences have different effects on abstinence motivation and substance use behavior. They therefore provide a focus that should be increasingly integrated into treatment concepts.
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Affiliation(s)
- Thomas Schnell
- Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany.
| | - Christina-Marie Grömm
- Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
| | - Nils Klöckner
- Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457, Hamburg, Germany
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Ceyhun HA. Psychiatric symptoms, current use of tobacco, alcohol, illicit drug, and poly-substance among medical students in Eastern Turkey. J Ethn Subst Abuse 2022; 21:1-28. [PMID: 36271892 DOI: 10.1080/15332640.2022.2135656] [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: 10/24/2022]
Abstract
The study aims to investigate the prevalence and patterns of substance use among medical students and to examine associated psychiatric symptoms. It has been observed that depression and psychoticism scores have a significant effect on smoking, and interpersonal sensitivity-hostility-paranoid ideation scores have a significant effect on drinking. It has been shown that interpersonal sensitivity and depression scores are more predictive of mono-and poly-substance use. Revealing the relationship between tobacco, alcohol, poly-substance use, and psychiatric symptoms in the medical school sample shows the importance of practices aimed at increasing students' awareness of their psychiatric symptoms and providing access to psychiatric services.
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Martins LC, Campos RC, Morujão IS. The mediating role of tolerance for psychological pain in the relationship of childhood trauma to suicidal ideation in individuals with a substance use disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:197-213. [PMID: 34658051 DOI: 10.1111/bjc.12338] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The association between childhood trauma and suicidal ideation has been well documented in several populations, including individuals with a substance use disorder (SUD). However, a gap still exists in the literature regarding the mechanisms by which childhood trauma later impacts suicide risk. This cross-sectional study tested the effect of childhood trauma on suicidal ideation, as well as the mediating effect of tolerance for psychological pain (managing the pain and enduring the pain) in that relationship, controlling for the effect of depressive symptoms, in individuals with a SUD. METHODS A sample of 102 adults with a SUD participated in the study. Path analysis by structural equation␣modelling tested a mediation model. RESULTS Depressive symptoms and lower levels of managing the pain were found to fully mediate the association between childhood trauma and suicidal ideation. CONCLUSIONS Our results suggest that depressive symptoms and a lack of ability to manage psychological pain contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions in individuals with SUDs. Moreover, they have relevant implications for prevention and clinical interventions regarding suicidal ideation in this population. PRACTITIONER POINTS Childhood trauma relates to suicidal ideation in individuals with a substance use disorder. Depressive symptoms contribute towards explaining why traumatic childhood experiences may result in suicidal cognitions. A lack of ability to manage psychological pain also contributes towards explaining this relationship. The obtained results have relevant implications for the prevention of and clinical intervention for suicidal ideation in SUD individuals.
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Affiliation(s)
- Luís C Martins
- Departamento de Psicologia, Escola de Ciências Sociais, Universidade de Évora, Portugal
| | - Rui C Campos
- Departamento de Psicologia, Escola de Ciências Sociais e Centro de Investigação em Educação e Psicologia (CIEP-UE), Universidade de Évora, Portugal
| | - Inês S Morujão
- Departamento de Psicologia, Escola de Ciências Sociais, Universidade de Évora, Portugal
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