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Mayorga NA, Manning KF, Viana AG, Buitron V, Argueta S, Zvolensky M. Evaluating the interactive impact of acculturative stress and anxiety sensitivity on behavioral health outcomes among Latinx during a period of high COVID-19 impact. Cogn Behav Ther 2024; 53:87-104. [PMID: 37929588 PMCID: PMC10841410 DOI: 10.1080/16506073.2023.2273794] [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: 05/17/2023] [Accepted: 10/17/2023] [Indexed: 11/07/2023]
Abstract
As a multi-systemic disease, COVID-19 infection engendered a rise in co-occurring mental and physical health symptoms, particularly affecting the Latinx population. The current work sought to evaluate the main and interactive influence of acculturative stress and anxiety sensitivity in terms of mental and physical health symptoms among 181 Latinx persons (30.4% female, Mage = 34.1 years, SD = 8.20). Data were collected during a period of high COVID-19 impact (2020-2021) and analyses included five separate, two-step hierarchical regressions that were conducted for each of the criterion variables: (1) fear of coronavirus; (2) somatic symptoms; (3) fatigue severity; (4) anxiety symptoms; and (5) depression symptoms. For all analyses, step 1 covariates included years living in the U.S. COVID-19 impact, gender identity, education, and work life distress and home life distress. Results revealed an interactive effect of anxiety sensitivity and acculturative stress on COVID-19 fear, unique main effects for both anxiety sensitivity and acculturative stress on COVID-19 related fear and somatic symptoms, and main effects for anxiety sensitivity alone in relation to fatigue severity, anxiety, and depression. Overall, this study represents an initial investigation of the associations between acculturative stress, anxiety sensitivity, and a range of salient COVID-19 related outcomes among Latinx persons.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Kara F Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Victor Buitron
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Salma Argueta
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael 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
- HEALTH Institute, University of Houston, Houston, TX, USA
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2
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Whiteford S, Quigley M, Dighton G, Wood K, Kitchiner N, Armour C, Dymond S. Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans. J Clin Psychol 2024; 80:158-169. [PMID: 37860949 DOI: 10.1002/jclp.23604] [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: 01/24/2023] [Revised: 09/07/2023] [Accepted: 09/30/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Little is known about whether distress tolerance and anxiety mediate the relationship between comorbid complex posttraumatic stress disorder (CPTSD) and alcohol use among military veterans. Here, we investigated the contribution of distress tolerance and anxiety on the strength of the CPTSD and alcohol use association. We hypothesized that the impact of a two-factor model of CPTSD derived from subscale scores on the International Trauma Questionnaire (ITQ)-namely ITQ PTSD and ITQ Disturbances in Self Organization (DSO; e.g., issues with affective regulation/self-belief and shame)-on alcohol use severity would be mediated by anxiety but not by distress tolerance. METHODS Participants included 403 community-dwelling United Kingdom (UK) veterans (91.64% male, Mage = 51.15 years, SD = 12.48) recruited as part of a larger, online study. RESULTS Findings indicated that the influence of CPTSD symptoms on alcohol use severity was mediated by anxiety, not by distress tolerance, with greater relative impact due to ITQ DSO status than ITQ PTSD status. CONCLUSIONS We identified the mediational influence of anxiety and distress tolerance on the association between CPTSD subscales and alcohol use in UK veterans. Interventions for anxiety may be adapted for reducing problematic alcohol use and the impact of CPTSD symptoms in veterans with comorbid PTSD and alcohol use disorder.
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Affiliation(s)
- Seb Whiteford
- School of Psychology, Swansea University, Swansea, UK
| | | | - Glen Dighton
- School of Psychology, Swansea University, Swansea, UK
| | - Katie Wood
- School of Psychology, Swansea University, Swansea, UK
| | - Neil Kitchiner
- Veterans NHS Wales, Cardiff and Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Cherie Armour
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
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3
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Gocet Tekin E, Yilmaz FB, Satici SA. Impulsivity and substance misuse among Turkish people: Serial mediating effect of emotion dysregulation and general anxiety disorder. J Ethn Subst Abuse 2023:1-18. [PMID: 37812504 DOI: 10.1080/15332640.2023.2263742] [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: 10/11/2023]
Abstract
Substance misuse is an alarming issue worldwide that causes serious problems at both the individual and societal levels, placing a burden on public health systems and economies. Understanding the predictors of substance misuse may help prevent it and may be an adjunct to treatment. The present study examined the relationship among impulsivity, emotion dysregulation, generalized anxiety disorder, and substance misuse. A total of 462 participants age between 18 and 74 years (M = 33.67, SD = 12.91) from 49 cities across Türkiye, completed the measures of impulsivity, emotion dysregulation, generalized anxiety disorder, and substance misuse. Structural equation modeling indicated that impulsivity, emotion dysregulation, and generalized anxiety have a significant predictive role in substance misuse. Further, emotion dysregulation and generalized anxiety disorder mediate the relationship between impulsivity and substance misuse. These findings suggest that noticing and treating impulsivity, emotion dysregulation, and generalized anxiety may minimize the effects of substance misuse.
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Gette JA, Nosen E, Schumacher JA. Predicting Reasons for Drinking in a Dually-Diagnosed Sample with PTSD and Substance Use Disorders. Subst Use Misuse 2023; 58:1438-1446. [PMID: 37331791 DOI: 10.1080/10826084.2023.2223300] [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] [Indexed: 06/20/2023]
Abstract
Objective: Using the negative reinforcement and common factors frameworks, this work assessed whether and how anxiety sensitivity, distress tolerance, and impulsivity relate to reasons for drinking (RFD) in a residential treatment sample with co-occurring alcohol use disorder and posttraumatic stress disorder (AUD-PTSD). Demographic differences were also examined. Method: Participants were 75 (52.0% male, 78.7% white) adults at a residential substance use treatment facility who met criteria for AUD-PTSD with 98.67% meeting criteria for one or more substance use disorders in addition to AUD. Participants completed measures of anxiety sensitivity, distress tolerance, impulsivity, RFD, and AUD-PTSD symptoms. Univariate and multivariate linear regression was used with and without controlling for demographic variables (i.e., age, race, and sex). Results: The positive and negative urgency facets of impulsivity were positively related to both negative affect and cue/craving response RFD with relations maintained after controlling for demographic variables and including PTSD symptom severity (βs .30-.51). There were no significant relations between impulsivity and social RFD. No facets of anxiety sensitivity or distress tolerance were significantly related to RFD domains. Conclusions: Findings suggest that the urgency facets of impulsivity are crucial in understanding negative affect and cue/craving RFD. However, anxiety sensitivity and distress tolerance are not related to RFD in this dually diagnosed AUD-PTSD sample. Treatment considerations and future directions are discussed.
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Affiliation(s)
- J A Gette
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - E Nosen
- G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, Mississippi, USA
| | - J A Schumacher
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
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5
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Bimstein JG, O'Bryan EM, Jean A, McLeish AC. Intolerance of Uncertainty, Negative Reinforcement Alcohol Use Motives, and Hazardous Drinking in College Students with Clinically Elevated Worry. Subst Use Misuse 2023:1-8. [PMID: 37270428 DOI: 10.1080/10826084.2023.2215318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Background: Hazardous drinking has remained high for college students in recent years, and individuals who endorse drinking to cope with emotional distress or to conform socially report higher levels of alcohol use. Intolerance of uncertainty, a core process underlying generalized anxiety disorder, has been linked to negative reinforcement drinking motives; however, no research, to date, has examined the role of intolerance of uncertainty in terms of alcohol use motives and hazardous drinking among individuals with generalized anxiety disorder. Objective: The current study was designed to examine the relationships between intolerance of uncertainty, coping and conformity alcohol use motives, and hazardous drinking in an analogue generalized anxiety disorder sample. Methods: Participants were 323 college students (Mage = 19.25, SD = 2.23, Range = 18-40) who endorsed past-year alcohol use and clinically elevated levels of worry. Self-report measures were completed online for course credit. Results: Partially consistent with our hypotheses, uncertainty paralysis predicted greater levels of coping motives, but not conformity motives. Desire for predictability did not predict either drinking motive. Mediation analyses revealed that there was a significant indirect effect of uncertainty paralysis on more hazardous drinking through greater coping motives. Conclusion: Overall, these findings highlight the potential utility of targeting behavioral inhibition due to uncertainty to reduce unhealthy coping via alcohol use and subsequent hazardous alcohol use.
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Affiliation(s)
- Jessica G Bimstein
- Anxiety Disorders Center, Hartford Hospital/Institute of Living, Hartford, Connecticut, USA
| | - Emily M O'Bryan
- Anxiety Disorders Center, Hartford Hospital/Institute of Living, Hartford, Connecticut, USA
- Endicott College, Beverly, Massachusetts, USA
- University of Cincinnati, Cincinnati, Ohio, USA
| | - Anishka Jean
- Anxiety Disorders Center, Hartford Hospital/Institute of Living, Hartford, Connecticut, USA
| | - Alison C McLeish
- University of Cincinnati, Cincinnati, Ohio, USA
- University of Louisville, Louisville, Kentucky, USA
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6
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Wolitzky-Taylor K, Smit T, Vujanovic AA, Zvolensky MJ. Transdiagnostic Processes Linking Posttraumatic Stress Disorder Symptoms to Alcohol Use Severity. J Dual Diagn 2023; 19:97-110. [PMID: 37389859 DOI: 10.1080/15504263.2023.2225373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Objective: The high comorbidity between posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is well-established and complex. However, there is a need to explore transdiagnostic constructs that may underlie this association to better understand what accounts for this comorbidity and to inform treatment development. Method: Thus, the present study utilized a large, cross-sectional dataset (N = 513; Mage = 38.25 years, SD = 10.07; 49.9% female), based on national recruitment, to (1) examine whether the associations between PTSD symptom severity (PCL-5) and alcohol use severity (AUDIT) were statistically mediated by (a) anxiety sensitivity (SSASI); and (b) difficulties with emotion regulation (DERS-16); and (2) examine whether coping motives for drinking moderate this indirect effect. Sex assigned at birth was included as a covariate. Results: When examining the hypothesized mediators (SSASI and DERS-16) in separate models, there was a statistically significant indirect effect of PCL-5 on AUDIT through both SSASI and DERS. However, when both SSASI and DERS were entered into a model simultaneously, only SSASI served as a statistically significant mediator. Coping motives for drinking did not moderate the observed indirect effect. Conclusions: The current findings highlight anxiety sensitivity and emotion regulation as transdiagnostic processes that may explain, at least partially, the relationship between PTSD symptom severity and alcohol use; however, stronger evidence was evident for anxiety sensitivity. These findings may help inform the development of refined, streamlined interventions for PTSD and alcohol use that directly target these processes.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California - Los Angeles, Los Angeles, California, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Psarianos A, Chryssanthopoulos C, Paparrigopoulos T, Philippou A. The Role of Physical Exercise in Opioid Substitution Therapy: Mechanisms of Sequential Effects. Int J Mol Sci 2023; 24:ijms24054763. [PMID: 36902190 PMCID: PMC10003472 DOI: 10.3390/ijms24054763] [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: 01/07/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
It is generally accepted that chronic opioid use is associated with structural and functional changes in the human brain that lead to an enhancement of impulsive behavior for immediate satisfaction. Interestingly, in recent years, physical exercise interventions have been used as an adjunctive treatment for patients with opioid use disorders (OUDs). Indeed, exercise has positive effects on both the biological and psychosocial basis of addiction, modifying neural circuits such as the reward, inhibition, and stress systems, and thus causing behavioral changes. This review focuses on the possible mechanisms that contribute to the beneficial effects of exercise on the treatment of OUDs, with emphasis placed on the description of a sequential consolidation of these mechanisms. Exercise is thought to act initially as a factor of internal activation and self-regulation and eventually as a factor of commitment. This approach suggests a sequential (temporal) consolidation of the functions of exercise in favor of gradual disengagement from addiction. Particularly, the sequence in which the exercise-induced mechanisms are consolidated follows the pattern of internal activation-self-regulation-commitment, eventually resulting in stimulation of the endocannabinoid and endogenous opioid systems. Additionally, this is accompanied by modification of molecular and behavioral aspects of opioid addiction. Overall, the neurobiological actions of exercise in combination with certain psychological mechanisms appear to promote its beneficial effects. Given the positive effects of exercise on both physical and mental health, exercise prescription is recommended as a complement to conventional therapy for patients on opioid maintenance treatment.
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Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Belay GM, Lam KKW, Liu Q, Wu CST, Mak YW, Ho KY. Magnitude and determinants of alcohol use disorder among adult population in East Asian countries: A systematic review and meta-analysis. Front Public Health 2023; 11:1144012. [PMID: 36926176 PMCID: PMC10011711 DOI: 10.3389/fpubh.2023.1144012] [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: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol use despite adverse health outcomes. Despite several studies that have analyzed the prevalence and determinants, their results have been equivocal, and the reasons for the differences in prevalence rates and determinants of AUD across nationalities are unknown. Hence, this study estimated the pooled prevalence of alcohol use disorder and its determinant among adults in East Asian countries. Methods Articles were searched from PubMed, Web of Science, EMBASE, PsycINFO, and Scopus. All observational study designs that fulfilled the predefined criteria were included in the study. The findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The quality and heterogeneity of articles were assessed using the new castle-Ottawa scale (NOS) and I2, respectively. Additionally, publication bias was checked through funnel plot and Egger's regression test. Results A total of 14 articles with 93, 161 study participants were considered in the study. Of which 9 studies were included in the meta-analysis of the 1-year prevalence of alcohol use disorder, 6 in the lifetime, 9 in alcohol abuse, and 8 in alcohol dependency. Consequently, the overall pooled prevalence of one-year alcohol use disorder was 8.88% (95% CI: 6.32, 11.44), lifetime 13.41% (95%CI: 8.48, 18.34), alcohol abuse 5.4% (95% CI: 2.66, 8.13), and alcohol dependency 4.47% (95% CI: 2.66, 6.27). In the subgroup analysis by country, the highest 1-year and lifetime pooled prevalence of alcohol use disorder was observed in Korea at 9.78% (95% CI:4.40, 15.15) and 16.73% (95% CI: 15.31, 18.16), respectively. Besides, smoking (OR: 3.99; 95% CI: 1.65, 6.33) and male gender (OR: 5.9; 95% CI: 3.3, 8.51) were significant determinants of alcohol use disorder. Conclusions The magnitude of alcohol use disorder was high among adults in East Asian countries. Smoking and male gender were the key determinants of alcohol use disorders.
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Affiliation(s)
| | | | | | | | | | - Ka Yan Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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9
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Lebeaut A, Pedersen ER, Francis DJ, Zvolensky MJ, Vujanovic AA. Evaluation of an integrated personalized feedback intervention for hazardous drinkers with elevated anxiety sensitivity and PTSD symptoms: Protocol for a randomized controlled trial. Contemp Clin Trials Commun 2023; 32:101088. [PMID: 36824449 PMCID: PMC9941063 DOI: 10.1016/j.conctc.2023.101088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/05/2023] Open
Abstract
Background Hazardous drinking and posttraumatic stress disorder (PTSD) are commonly co-occurring conditions among adults. Motivational enhancement interventions, such as personalized feedback interventions (PFI), have demonstrated efficacy for reducing hazardous drinking. Emerging though scant literature has evaluated PFI for co-occurring PTSD and hazardous alcohol use. A transdiagnostic risk factor that may underlie this co-occurrence and inform novel PFI development is anxiety sensitivity (AS). Objective To use a randomized controlled trial to evaluate the efficacy of a novel, computer-based PFI for hazardous drinkers with at least subclinical PTSD and elevated AS (AP-PFI), against a time-matched comparison condition (C-PFI). Methods Participants (N = 100) will be recruited and enrolled from the Houston, TX community. The study includes: an in-person visit (baseline diagnostic assessment, a brief intervention, and a post-intervention assessment) and two follow-up assessments (1-week and 1-month). Participants who meet study inclusion criteria will be randomized to one of two conditions at baseline: AP-PFI or C-PFI. AP-PFI will consist of a brief, single-session, computer-delivered, PFI-based intervention that provides integrative and normative feedback about alcohol use, AS, and PTSD symptoms. C-PFI will be time-matched but will only include alcohol-related feedback. Conclusions AP-PFI is designed to provide feedback about alcohol use, PTSD symptoms, and AS and their interplay and deliver psychoeducation on harm-reduction techniques, interoceptive exposure exercises, and stress management strategies. The intervention may address extant gaps in treatment for these co-occurring conditions by providing a brief, evidence-based, motivational enhancement intervention that is cost-effective with potential to be disseminated across a variety of healthcare settings.
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Affiliation(s)
- Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, TX, USA,Corresponding authors.
| | - Eric R. Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - David J. Francis
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Anka A. Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA,Corresponding authors.
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McCabe CJ, Brumback T, Brown SA, Meruelo AD. Assessing cross-lagged associations between depression, anxiety, and binge drinking in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) study. Drug Alcohol Depend 2023; 243:109761. [PMID: 36621201 PMCID: PMC10122417 DOI: 10.1016/j.drugalcdep.2022.109761] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/01/2022] [Accepted: 12/24/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Between 20 % and 30 % of teens suffer from depression or anxiety before reaching adulthood, and up to half also use or misuse alcohol. Although theories suggest bidirectional links between harmful alcohol use (e.g., binge drinking) and internalizing symptoms (i.e., depression and anxiety), empirical evidence to-date has been mixed. Systematic reviews have attributed mixed findings to limitations in study design, such as the utilization of between-person analyses and the focus on unidirectional effects. The goal of this study was to address these limitations by assessing bidirectional within-person associations between internalizing symptoms and binge drinking over the course of 5 years in the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) sample, a large cohort recruited at ages 12-21 and followed annually on substance use and psychiatric functioning. METHODS We used latent curve models with structured residuals to examine within-person lagged associations between depression, anxiety, and past month counts of binge drinking using NCANDA data (N = 831). Analyses were supplemented with post-hoc power simulations. RESULTS We found marginal evidence linking binge drinking with subsequent depression symptoms one year later among females. We found no evidence that depression or anxiety predicted subsequent binge drinking despite sufficient power. CONCLUSIONS Social and cognitive consequences of binge drinking may predict later depression symptoms in adolescence and young adulthood for young women, though there was little evidence favoring self-medication models for binge drinking. We note several moderating variables and common factor mechanisms that may better explain this link.
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11
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Karnick AT, Buerke M, Caulfied N, Trussell D, Capron DW, Vujanovic A. Alcohol use in firefighters: A network model of behaviors and transdiagnostic risk. Drug Alcohol Depend 2022; 241:109677. [PMID: 36334469 DOI: 10.1016/j.drugalcdep.2022.109677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS Firefighters are at heightened risk for developing alcohol use disorder (AUD), possibly due to chronic stress and exposure to potentially traumatic events. Daily trauma experiences and transdiagnostic risk factors (i.e., anxiety sensitivity and distress intolerance) are related to posttraumatic stress and depressive symptoms, as well as alcohol use severity and alcohol as a coping strategy. Although alcohol use has been identified as a key target for addressing mental health in firefighters, prior research has not fully integrated transdiagnostic vulnerabilities, internalizing symptoms, posttraumatic stress symptoms, alcohol coping, and overall alcohol use into a dynamic network model. METHODS We assessed the symptom structure of overall alcohol use in firefighters with a likely AUD and transdiagnostic risk factors in all firefighters using network analysis. RESULTS Failing to meet expectations (Expected Influence [EI]: 1.32), morning dependence (EI: 1.07), and guilt about drinking (EI: 1.10) were most central to the network model developed for firefighters with a likely AUD. In a transdiagnostic model of use in firefighters overall, anxiety sensitivity cognitive concerns (EI: 1.48) and negative alterations to cognitions and mood related to trauma (EI: 1.87) had the highest influence on the network. Notable correlations were also identified between trauma arousal and overall alcohol use, between depression and alcohol coping motives, and between trauma avoidance and alcohol coping motives. CONCLUSIONS Alcohol use behaviors may follow a unique etiologic pathway in firefighters and intervention strategies should target factors found to be more central to symptom networks.
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Affiliation(s)
- Aleksandr T Karnick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA.
| | - Morgan Buerke
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Nicole Caulfied
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Dylan Trussell
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Daniel W Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39402, USA
| | - Anka Vujanovic
- Department of Psychology, University of Houston, Houston, TX 77204, USA.
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12
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Brown CS, Amir N. The moderating effect of anxiety diagnosis on the relationship between error-related negativity and anxiety sensitivity cognitive concerns. Biol Psychol 2022; 175:108443. [DOI: 10.1016/j.biopsycho.2022.108443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/14/2022] [Accepted: 10/09/2022] [Indexed: 11/02/2022]
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13
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MacKay E, Deacon SH, Elgendi MM, Stewart SH. Drinking among university students with a history of reading difficulties: motivational and personality risk factors for hazardous levels of consumption. ANNALS OF DYSLEXIA 2022; 72:487-508. [PMID: 35976521 DOI: 10.1007/s11881-022-00266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/16/2022] [Indexed: 06/15/2023]
Abstract
An increasing number of students are entering university with reading difficulties-whether they be diagnosed or self-reported. Research demonstrates that university students who self-report a history of reading difficulties (HRD) have lower academic achievement and higher anxiety about academic performance as compared to peers without this history (NRD). Here we study other aspects of HRD students' university experiences, focusing on alcohol consumption. Specifically, we investigated the drinking motives and personality characteristics likely to increase risk of hazardous alcohol consumption among HRD vs. NRD undergraduates. We identified 42 HRD and 54 NRD participants based on responses to a reading history questionnaire. Participants completed questionnaires assessing hazardous drinking, drinking motives, and alcohol-risk personality traits. Both groups reported similarly high levels of hazardous drinking. HRD students reported drinking more to conform with peers, and less to enhance positive moods, than NRD students. HRD students also scored higher in the alcohol personality risk of impulsivity. Our results support a unique pattern of motives and personality risks among HRD students, a pattern that likely puts them at increased risk for sustained hazardous drinking. Clinical implications for preventing problem drinking among HRD undergraduates are considered.
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Affiliation(s)
- Elizabeth MacKay
- Dalhousie University, P. O. Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - S Hélène Deacon
- Dalhousie University, P. O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Mariam M Elgendi
- Dalhousie University, P. O. Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Sherry H Stewart
- Dalhousie University, P. O. Box 15000, Halifax, NS, B3H 4R2, Canada
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Binge-like Prenatal Ethanol Exposure Causes Impaired Cellular Differentiation in the Embryonic Forebrain and Synaptic and Behavioral Defects in Adult Mice. Brain Sci 2022; 12:brainsci12060793. [PMID: 35741678 PMCID: PMC9220802 DOI: 10.3390/brainsci12060793] [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: 04/27/2022] [Revised: 06/10/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Abstract
An embryo’s in-utero exposure to ethanol due to a mother’s alcohol drinking results in a range of deficits in the child that are collectively termed fetal alcohol spectrum disorders (FASDs). Prenatal ethanol exposure is one of the leading causes of preventable intellectual disability. Its neurobehavioral underpinnings warrant systematic research. We investigated the immediate effects on embryos of acute prenatal ethanol exposure during gestational days (GDs) and the influence of such exposure on persistent neurobehavioral deficits in adult offspring. We administered pregnant C57BL/6J mice with ethanol (1.75 g/kg) (GDE) or saline (GDS) intraperitoneally (i.p.) at 0 h and again at 2 h intervals on GD 8 and GD 12. Subsequently, we assessed apoptosis, differentiation, and signaling events in embryo forebrains (E13.5; GD13.5). Long-lasting effects of GDE were evaluated via a behavioral test battery. We also determined the long-term potentiation and synaptic plasticity-related protein expression in adult hippocampal tissue. GDE caused apoptosis, inhibited differentiation, and reduced pERK and pCREB signaling and the expression of transcription factors Pax6 and Lhx2. GDE caused persistent spatial and social investigation memory deficits compared with saline controls, regardless of sex. Interestingly, GDE adult mice exhibited enhanced repetitive and anxiety-like behavior, irrespective of sex. GDE reduced synaptic plasticity-related protein expression and caused hippocampal synaptic plasticity (LTP and LTD) deficits in adult offspring. These findings demonstrate that binge-like ethanol exposure at the GD8 and GD12 developmental stages causes defects in pERK–pCREB signaling and reduces the expression of Pax6 and Lhx2, leading to impaired cellular differentiation during the embryonic stage. In the adult stage, binge-like ethanol exposure caused persistent synaptic and behavioral abnormalities in adult mice. Furthermore, the findings suggest that combining ethanol exposure at two sensitive stages (GD8 and GD12) causes deficits in synaptic plasticity-associated proteins (Arc, Egr1, Fgf1, GluR1, and GluN1), leading to persistent FASD-like neurobehavioral deficits in mice.
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Simon L, Souza-Smith FM, Molina PE. Alcohol-Associated Tissue Injury: Current Views on Pathophysiological Mechanisms. Annu Rev Physiol 2022; 84:87-112. [PMID: 35143331 DOI: 10.1146/annurev-physiol-060821-014008] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
At-risk alcohol use is a major contributor to the global health care burden and leads to preventable deaths and diseases including alcohol addiction, alcoholic liver disease, cardiovascular disease, diabetes, traumatic injuries, gastrointestinal diseases, cancers, and fetal alcohol syndrome. Excessive and frequent alcohol consumption has increasingly been linked to alcohol-associated tissue injury and pathophysiology, which have significant adverse effects on multiple organ systems. Extensive research in animal and in vitro models has elucidated the salient mechanisms involved in alcohol-induced tissue and organ injury. In some cases, these pathophysiological mechanisms are shared across organ systems. The major alcohol- and alcohol metabolite-mediated mechanisms include oxidative stress, inflammation and immunometabolic dysregulation, gut leak and dysbiosis, cell death, extracellular matrix remodeling, endoplasmic reticulum stress, mitochondrial dysfunction, and epigenomic modifications. These mechanisms are complex and interrelated, and determining the interplay among them will make it possible to identify how they synergistically or additively interact to cause alcohol-mediated multiorgan injury. In this article, we review the current understanding of pathophysiological mechanisms involved in alcohol-induced tissue injury.
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Affiliation(s)
- Liz Simon
- Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA;
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Flavia M Souza-Smith
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Patricia E Molina
- Comprehensive Alcohol-HIV/AIDS Research Center, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA;
- Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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16
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Randazza MP, McKay D, Bakhshaie J, Storch EA, Zvolensky MJ. Unhealthy Alcohol Use Associated with Obsessive-Compulsive Symptoms: The Moderating Effects of Anxiety and Depression. J Obsessive Compuls Relat Disord 2022; 32:100713. [PMID: 35242506 PMCID: PMC8887883 DOI: 10.1016/j.jocrd.2022.100713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol use occurs among individuals with obsessive-compulsive symptoms at a rate significantly greater than the general population. In clinical populations, obsessive-compulsive disorder (OCD) and substance use disorders (SUD) have been shown to share neurological substrates, but little is known about the mechanisms underlying substance use in individuals with OCD. Aspects of anxiety and depression frequently contribute to various SUD and are thought to play a role in the relationship between increased substance use and obsessive-compulsive symptomatology. The present research examines the moderating effects of depression and several anxiety-related constructs (anxious arousal, anxiety sensitivity, and social anxiety) on the relationship between health risk resulting from alcohol use and obsessive-compulsive symptoms in university students (n = 178). The physical concerns and social concerns subscales of the Anxiety Sensitivity Index increased the relationship between risky drinking and total OCD symptoms (as measured with the OCI-12). Additionally, general depression and social anxiety significantly increased the relationship between risky alcohol use and the obsessing dimension. All relationships were of a small to medium effect size. These findings help identify emotionally vulnerable subgroups of persons with OCD that may have greater liability for risky alcohol use.
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Affiliation(s)
- Michael P. Randazza
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA
| | - Dean McKay
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA
| | - Jafar Bakhshaie
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Eric A. Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX 77030, USA
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler St., Houston, TX 77030, USA
- HEALTH Institute, University of Houston, 4849 Calhoun Rd., Houston, TX 77204, USA
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17
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Weiss NH, Kiefer R, Goncharenko S, Raudales AM, Forkus SR, Schick MR, Contractor AA. Emotion regulation and substance use: A meta-analysis. Drug Alcohol Depend 2022; 230:109131. [PMID: 34864568 PMCID: PMC8714680 DOI: 10.1016/j.drugalcdep.2021.109131] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/26/2021] [Accepted: 09/30/2021] [Indexed: 01/03/2023]
Abstract
There has been exponential growth in research on emotion regulation and substance use in the past decade. The current meta-analysis evaluated variability in the magnitude of the relation between aspects of emotion regulation and substance use. A search of PsycINFO, Embase, PubMed, CINAHL Plus, and PILOTS in December 2020 resulted in 6642 initial studies, of which 95 met inclusion criteria (association between emotion regulation and substance use was reported, participants were > 18 years old, article was in English). A total of 445 effects were obtained (N = 156,025 participants; weighted Mage = 29.31; 59.5% female; 66.1% White; 76.6% non-clinical). Emotion regulation and substance use were significantly related (r = 0.19; p < 0.001; 95%CI [0.17, 0.20]). Emotion regulation abilities were generally more strongly related to substance use than emotion regulation strategies; this pattern was stronger for behavioral vs. cognitive abilities and extended to both negative and positive emotions. Relations were stronger for older and clinical samples; mixed effects were found for sex and no conclusive effects were found for race. Despite limitations of the existing literature (e.g., cross-sectional, self-reports), results indicated that the magnitude of the relation between emotion regulation and substance use varied considerably as a function of emotion regulation and substance use constructs and sample characteristics.
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18
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Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. J Affect Disord 2021; 295:1347-1359. [PMID: 34706448 DOI: 10.1016/j.jad.2021.08.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders. METHODS A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders. RESULTS All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders. CONCLUSION NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.
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Fitzgerald HE, Hoyt DL, Kredlow MA, Smits JAJ, Schmidt NB, Edmondson D, Otto MW. Anxiety Sensitivity as a Malleable Mechanistic Target for Prevention Interventions: A Meta-Analysis of the Efficacy of Brief Treatment Interventions. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2021; 28:323-337. [PMID: 35300171 PMCID: PMC8923531 DOI: 10.1037/cps0000038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Anxiety sensitivity (AS) is a transdiagnostic risk factor and potential treatment target for prevention of associated psychopathology and negative health behaviors. We conducted a meta-analysis evaluating the efficacy of brief interventions in at-risk samples for reducing AS and associated clinical/behavioral outcomes (e.g., depression, alcohol use) across 28 studies (1,998 participants). AS targeted interventions, compared to control conditions, evidenced a significant moderate effect size for alleviating AS from pre- to post-treatment (d = 0.54) and approached a large effect size from pre-treatment to short-term follow-up (d = 0.78). The effect size for long-term follow-up did not reach significance (d = 0.29). For clinical/behavioral outcomes, AS interventions demonstrated significant small-to-moderate effect sizes for the three timepoints examined (d's = 0.20-0.41). Our findings help validate AS as a modifiable mechanistic target for prevention efforts.
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Affiliation(s)
- Hayley E Fitzgerald
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - Danielle L Hoyt
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
| | - M Alexandra Kredlow
- Department of Psychology, Harvard University, 52 Oxford Street, Cambridge, MA 02140
| | - Jasper A J Smits
- Department of Psychology, Institute for Mental Health Research, University of Texas at Austin, 305 E. 23 St., Austin, TX 78712
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306
| | | | - Michael W Otto
- Psychological and Brain Sciences, Boston University, 900 Commonwealth Ave., 2 Floor, Boston, MA 02215
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20
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Zale EL, Powers JM, Ditre JW. Cognitive-Affective Transdiagnostic Factors Associated With Vulnerability to Alcohol and Prescription Opioid Use in the Context of Pain. Alcohol Res 2021; 41:08. [PMID: 34306903 PMCID: PMC8289456 DOI: 10.35946/arcr.v41.1.08] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The use of alcohol and prescription opioids is common among people in pain and poses significant public health burdens. This review identifies factors associated with motivation to use alcohol and prescription opioids in the context of pain. Pain-relevant, cognitive-affective, transdiagnostic vulnerability factors-expectancies/motives, pain catastrophizing, pain-related anxiety, distress intolerance, anxiety sensitivity, and perceived interrelations-were selected from theoretical conceptualizations of pain and substance use. Searches conducted in PubMed, PsycINFO, and Embase returned 25 studies that examined associations between identified variables of interest and the use of alcohol and prescription opioids in the context of pain. Consistent with a larger literature on pain and substance use, the studies included in this review demonstrated that people with chronic pain are motivated to use alcohol and opioids in response to negative affect and hold expectancies/motives for coping with pain. Vulnerabilities that engender difficulty managing aversive internal states (distress intolerance and anxiety sensitivity) and maladaptive responses to pain (pain-related anxiety and pain catastrophizing) also were implicated in motivation for alcohol and opioid use. Although one study found that pain-related anxiety was associated with co-use of alcohol and opioids, no studies examined simultaneous use. Future research directions that can explicate causal associations, identify patterns of alcohol and opioid co-use, clarify the role of pain in cessation processes, and inform treatment development are discussed.
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Affiliation(s)
- Emily L Zale
- Department of Psychology, Binghamton University, Binghamton, New York
| | - Jessica M Powers
- Department of Psychology, Syracuse University, Syracuse, New York
| | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, New York
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21
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Paulus DJ, Gallagher MW, Zvolensky MJ, Leventhal AM. Reciprocal longitudinal associations between anxiety sensitivity and alcohol consumption/problems across adolescence: Examining anxiety as a mediator and race/ethnicity as a moderator. Behav Res Ther 2021; 142:103861. [PMID: 34049078 PMCID: PMC8542277 DOI: 10.1016/j.brat.2021.103861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 03/16/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022]
Abstract
The conditions and populations for which anxiety sensitivity (AS; i.e., the tendency to interpret unpleasant physiological sensations as dangerous) relates to adolescent alcohol use is unclear. This study tested latent-variable cross-lagged panel modeling of AS-alcohol relations in a racially/ethnically heterogenous longitudinal youth cohort (N = 3396; 53.4% female, 45.8% Latinx) assessed annually across high school. Anxiety and race/ethnicity were tested as mediators and moderators, respectively, of AS-alcohol associations. AS prospectively predicted alcohol problems (β's = 0.05-0.07) but not alcohol consumption (β's = 0.02-0.04) across high school. Alcohol problems predicted AS at the end (β = 0.09) but not beginning (β's = 0.01-0.03) of high school and alcohol consumption predicted lower AS at the beginning (β = -0.06) but not end (β's = -0.02-0.01) of high school. Anxiety mediated AS's predictive effects on alcohol problems (βindirect's = 0.01, 95% CI [0.003, 0.03]) across high school. Race/ethnicity did not moderate interrelations of AS, anxiety, and alcohol outcomes. These findings lend support to the risk factor model of AS on alcohol problems (but not consumption) through anxiety and the scar/complication model whereby alcohol problems may exacerbate AS later in adolescence. Addressing reciprocal risk processes between AS, anxiety, and alcohol problems warrant consideration in adolescent behavioral health promotion for various racial/ethnic populations.
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Affiliation(s)
- Daniel J Paulus
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, United States.
| | - Matthew W Gallagher
- University of Houston, Department of Psychology, Houston, TX, United States; University of Houston, Texas Institute for Measurement, Evaluation, and Statistics, 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; Health Institute, University of Houston, Houston, TX, United States
| | - Adam M Leventhal
- University of Southern California Keck School of Medicine, Department of Preventative Medicine, Los Angeles, CA, United States; University of Southern California, Department of Psychology, Los Angeles, CA, United States
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22
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Qualitative approximations to causality: Non-randomizable factors in clinical psychology. CLINICAL PSYCHOLOGY IN EUROPE 2021; 3:e3873. [DOI: 10.32872/cpe.3873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022] Open
Abstract
Background
Causal quests in non-randomized studies are unavoidable just because research questions are beyond doubt causal (e.g., aetiology). Large progress during the last decades has enriched the methodical toolbox.
Aims
Summary papers mainly focus on quantitative and highly formal methods. With examples from clinical psychology, we show how qualitative approaches can inform on the necessity and feasibility of quantitative analysis and may yet sometimes approximate causal answers.
Results
Qualitative use is hidden in some quantitative methods. For instance, it may yet suffice to know the direction of bias for a tentative causal conclusion. Counterfactuals clarify what causal effects of changeable factors are, unravel what is required for a causal answer, but do not cover immutable causes like gender. Directed acyclic graphs (DAGs) address causal effects in a broader sense, may give rise to quantitative estimation or indicate that this is premature.
Conclusion
No method is generally sufficient or necessary. Any causal analysis must ground on qualification and should balance the harms of a false positive and a false negative conclusion in a specific context.
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23
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Hilton BT, Yusufov M, Rosellini AJ, Taghian NR, Weiss RD, Griffin ML, McHugh RK. Psychometric properties of the Anxiety Sensitivity Index-3 in adults with substance use disorders. J Subst Abuse Treat 2021; 132:108507. [PMID: 34214925 DOI: 10.1016/j.jsat.2021.108507] [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: 06/26/2020] [Revised: 05/25/2021] [Accepted: 05/26/2021] [Indexed: 11/18/2022]
Abstract
Anxiety sensitivity, or the fear of anxiety-related sensations, has demonstrated relevance to a broad range of psychiatric conditions, including substance use disorders (SUDs). Anxiety sensitivity is typically measured through self-report instruments, most commonly the Anxiety Sensitivity Index-3 (ASI-3). Despite the widespread use of the ASI-3 in studies of SUDs, little is known about its psychometric properties within this population. Patients on an inpatient detoxification unit seeking treatment for SUDs (N = 1248) completed a battery of self-report measures, including the ASI-3. Psychometric properties of the ASI-3 were examined. An exploratory factor analysis with half of the sample (n = 624) supported a 3-factor structure corresponding to the ASI-3 subscales (Social Concerns, Cognitive Concerns, Physical Concerns). Confirmatory factor analysis was used to validate this 3-dimensional structure in a separate subsample (n = 624), resulting in adequate fit when testing a second-order hierarchical model. Internal consistency and convergent and discriminant validity results also supported the use of the ASI-3 in people with SUDs. Despite its widespread use in SUD research, this is the first psychometric investigation of the ASI-3 among individuals seeking treatment for SUDs.
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Affiliation(s)
- Blake T Hilton
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America.
| | - Miryam Yusufov
- Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America; Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, 450 Brookline Avenue, JF 707, Boston, MA 02215, United States of America
| | - Anthony J Rosellini
- Center for Anxiety and Related Disorders, Department of Psychological and Brain Sciences, Boston University, 900 Commonwealth Avenue, Boston, MA 02215, United States of America
| | - Nadine R Taghian
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America
| | - Roger D Weiss
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - Margaret L Griffin
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
| | - R Kathryn McHugh
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States of America; Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, United States of America
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24
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Raines AM, Ennis CR, Allan NP, McGrew SJ, Walton JL, Rogers AH, Zvolensky MJ, Schmidt NB, Laurel Franklin C. Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants. Addict Behav 2021; 116:106791. [PMID: 33497865 DOI: 10.1016/j.addbeh.2020.106791] [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: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. METHODS The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. RESULTS AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. CONCLUSIONS Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
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25
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Knapp AA, Allan NP, Cloutier R, Blumenthal H, Moradi S, Budney AJ, Lord SE. Effects of anxiety sensitivity on cannabis, alcohol, and nicotine use among adolescents: evaluating pathways through anxiety, withdrawal symptoms, and coping motives. J Behav Med 2021; 44:187-201. [PMID: 32980966 PMCID: PMC7965231 DOI: 10.1007/s10865-020-00182-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 09/05/2020] [Indexed: 12/14/2022]
Abstract
Anxiety sensitivity (AS) is a promising intervention target due to its relevance to negative health behaviors broadly, and substance use specifically. The aim of the current study was to evaluate the direct and indirect pathways through which elevated AS could relate to recent substance use among a national adolescent sample recruited via social-media. As predicted, AS was indirectly associated with greater likelihood of using alcohol, cigarettes, and electronic nicotine delivery systems in the past-month through anxiety symptoms. Regarding cannabis, AS was directly related to increased likelihood of past-month cannabis use; however, the indirect relation between AS and likelihood of past-month use via anxiety symptoms was not significant. Through chained indirect effects, AS was related positively to past-month alcohol and cannabis use via anxiety symptoms and coping-related motives, and through withdrawal symptoms and coping-related motives. Study findings can be used to generate hypotheses on potential pathways through which AS could prospectively relate to substance use among youth.
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Affiliation(s)
- Ashley A Knapp
- Department of Preventive Medicine, Center for Behavioral Intervention Technologies, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr. 10th Floor, Chicago, IL, 60611, USA.
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA.
| | - Nicholas P Allan
- Department of Psychology, Ohio University, Porter Hall 209, Athens, OH, 45701, USA
| | - Renee Cloutier
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Heidemarie Blumenthal
- Teen Stress and Alcohol Research Laboratory, Department of Psychology, University of North Texas, 1155 Union Circle #311280, Denton, TX, 76203, USA
| | - Shahrzad Moradi
- Department of Psychology, Ohio University, Porter Hall 209, Athens, OH, 45701, USA
| | - Alan J Budney
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA
| | - Sarah E Lord
- Center for Technology and Behavioral Health, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Lebanon, NH, 03766, USA
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26
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Kremyar AJ, Lee TTC. MMPI-3 Predictors of Anxiety Sensitivity and Distress Intolerance. Assessment 2021; 29:1103-1116. [PMID: 33759600 DOI: 10.1177/10731911211001948] [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: 11/15/2022]
Abstract
Documenting empirical correlates of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) scale scores is important for expanding the clinical utility of the instrument. To this end, the goals of the current study were to examine associations between scores on MMPI-3 scales and measures of anxiety sensitivity and distress intolerance, two constructs reflecting intolerance of negative emotional states that are implicated in many psychological conditions, and to identify the scales that most strongly predict each construct. Using a sample of 287 undergraduate students (71% women; Mage = 18.90, SD = 1.12; 85% White), zero-order correlational, regression, and dominance analyses were performed to address these goals. Results indicate that when MMPI-3 scale scores are considered conjointly by scale family, they predict meaningful variance in anxiety sensitivity and distress intolerance measure scores, with conceptually implicated scales offering the strongest prediction across scale families. Implications for both research and practice, limitations, and future research directions are discussed.
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27
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Paulus DJ, Gallagher MW, Neighbors C, Zvolensky MJ. Computer-delivered personalized feedback intervention for hazardous drinkers with elevated anxiety sensitivity: A pilot randomized controlled trial. Behav Res Ther 2021; 141:103847. [PMID: 33813352 DOI: 10.1016/j.brat.2021.103847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/05/2020] [Accepted: 03/15/2021] [Indexed: 12/29/2022]
Abstract
Hazardous drinkers with emotional vulnerabilities (e.g., elevated anxiety sensitivity) remain an underserved group. This study aimed to evaluate the feasibility, acceptability, and initial efficacy of a single session remotely-delivered personalized feedback intervention (PFI) targeting alcohol (mis)use and anxiety sensitivity among college students. Hazardous drinkers with elevated anxiety sensitivity (N = 125; 76.8% female; Mage = 22.14; 66.4% racial/ethnic minorities) were randomized to receive the integrated PFI (n = 63) or attention control (n = 62). Follow-up assessments were conducted one-week, one-month and three-months post-intervention. Latent growth curve modeling was used to test pilot outcomes. It was feasible to recruit and retain hazardous drinking students with elevated anxiety sensitivity through follow-up with no group differences in retention. The integrated PFI was rated as more acceptable than the control with medium/large differences (p's < 0.004; d's = 0.54-0.80). The integrated PFI group had statistically significantly greater change in primary outcomes: motivation, hazardous alcohol use, and anxiety sensitivity (p's < 0.05; d's = 0.08-0.37) with larger within-group effect sizes (d's = 0.48-0.61) than in control (d's = 0.26-0.54). Despite a small sample size, this one-session intervention offers promise among a high-risk group of drinkers with emotional vulnerabilities. The computer-based format may allow for mass distribution of a low-cost intervention in the future; however, follow-up testing in larger samples is needed.
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Affiliation(s)
- Daniel J Paulus
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, 15213, USA.
| | - Matthew W Gallagher
- University of Houston, Department of Psychology, Houston, TX, 77204, USA; University of Houston, Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX, 77204, USA
| | - Clayton Neighbors
- University of Houston, Department of Psychology, Houston, TX, 77204, USA
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, 77204, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, 77030, USA; Health Institute, University of Houston, Houston, TX, 77204, USA
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The Mediating Effects of Protective Behavioral Strategies on the Relationship between Addiction-Prone Personality Traits and Alcohol-Related Problems among Emerging Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041814. [PMID: 33673396 PMCID: PMC7917822 DOI: 10.3390/ijerph18041814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/16/2022]
Abstract
Alcohol consumption and associated harms are an issue among emerging adults, and protective behavioral strategies (PBS) are actions with potential to minimize these harms. We conducted two studies aimed at determining whether the associations of at-risk personality traits (sensation-seeking [SS], impulsivity [IMP], hopelessness [HOP], and anxiety-sensitivity [AS]) with increased problematic alcohol use could be explained through these variables' associations with decreased PBS use. We tested two mediation models in which the relationship between at-risk personality traits and increased problematic alcohol use outcomes (Study 1: Alcohol volume; Study 2: Heavy episodic drinking and alcohol-related harms) was partially mediated through decreased PBS use. Two samples of college students participated (N1 = 922, Mage1 = 20.11, 70.3% female; N2 = 1625, Mage2 = 18.78, 70.3% female). Results partially supported our hypotheses, providing new data on a mechanism that helps to explain the relationships between certain at-risk personality traits and problematic alcohol use, as these personalities are less likely to use PBS. In contrast, results showed that AS was positively related to alcohol-related harms and positively related to PBS, with the mediational path through PBS use being protective against problematic alcohol use. This pattern suggests that there are other factors/mediators working against the protective PBS pathway such that, overall, AS still presents risks for alcohol-related harms.
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Hartmann SA, McLeish AC. Associations Between Transdiagnostic Cognitive-Affective Vulnerability Factors, Negative Reinforcement Drinking Motives, and Problematic Alcohol Use among Undergraduates. J Dual Diagn 2021; 17:13-22. [PMID: 33170111 DOI: 10.1080/15504263.2020.1828671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Anxiety sensitivity, distress tolerance, and emotion regulation difficulties have each demonstrated significant individual associations with problematic alcohol use and negative reinforcement motives for alcohol use among college students. However, extant research has yet to examine these three factors simultaneously with regard to the possibility of differential associations with alcohol consumption, alcohol-related problems and coping and conformity motives for alcohol use. As such, the present study sought to examine whether such differential associations exist within a sample of undergraduates reporting past year alcohol use. Methods: Participants were 379 undergraduate students reporting alcohol use in the past year who completed self-report measures for course credit. Results: After controlling for the effects of sex, lifetime marijuana use status, and negative affectivity, greater anxiety sensitivity social concerns and difficulties with emotional awareness were associated with more alcohol-related problems. Greater anxiety sensitivity social concerns and impulse control difficulties were associated with greater conformity alcohol use motives, and greater impulse control and emotional clarity difficulties were associated with greater coping motives. Conclusions: These findings suggest that greater fears of anxiety symptoms because of their potential negative social consequences and certain emotion regulation difficulties (i.e., impulse control, emotional clarity, emotional awareness) may be particularly problematic because they are associated with alcohol-related problems and negative reinforcement motives for use among undergraduates.
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Affiliation(s)
- Sarah A Hartmann
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Alison C McLeish
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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Stathopoulou G, Gold AK, Hoyt DL, Milligan M, Hearon BA, Otto MW. Does anxiety sensitivity predict addiction severity in opioid use disorder? Addict Behav 2021; 112:106644. [PMID: 32987306 DOI: 10.1016/j.addbeh.2020.106644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/03/2020] [Accepted: 09/02/2020] [Indexed: 01/23/2023]
Abstract
Increased anxiety sensitivity (AS), or the fear of anxiety-related cognitive, social, and physical symptoms which are misinterpreted as having harmful implications, has shown a relationship with substance use disorders. People with substance use disorders also experience addiction-related problems across domains of life functioning. However, few studies have evaluated the relationship between elevated AS and addiction-related problems across specific life areas. We evaluated, first, whether AS predicted addiction-related problems in a sample of treatment-refractory outpatients with opioid use disorders and, second, whether sex moderated the relationship between AS and addiction-related problems in this sample. Participants with treatment-refractory opioid use disorders (n = 92, 53.3% male) completed baseline assessments of AS (the Anxiety Sensitivity Index) and addiction-related problems (the Addiction Severity Index). Baseline AS total score was a significant independent predictor of both baseline Addiction Severity Index medical status (β = 0.29, t = 2.84, p = .006) and psychiatric status (β = 0.30, t = 2.99, p = .004) composite scores but was not associated with social, employment or legal difficulties. These findings were maintained when controlling for drug use severity, though baseline AS total score became a significant predictor of baseline legal difficulties (β = -0.23, t = -2.25, p = .027). There was no moderating role of sex on the relationship between baseline AS and addiction-related problems. Our findings suggest that, regardless of sex, elevated AS predicts increased addiction-related medical and psychiatric problems, and decreased legal problems when accounting for drug use severity, in outpatients with opioid use disorders.
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Paulus DJ, Capron DW, Zvolensky MJ. Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor. Cogn Behav Ther 2020; 50:378-394. [DOI: 10.1080/16506073.2020.1840622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Daniel J. Paulus
- Department of Neuroscience, Medical University of South Carolina, Charlestion, SC, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Daniel W. Capron
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, 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
- Health Institute, University of Houston, Houston, TX, USA
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Brown AL, España RA, Benca-Bachman CE, Welsh JW, Palmer RHC. Adolescent Behavioral Characteristics Mediate Familial Effects on Alcohol Use and Problems in College-Bound Students. Subst Abuse 2020; 14:1178221820970925. [PMID: 33223834 PMCID: PMC7656872 DOI: 10.1177/1178221820970925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Studies suggest a broad spectrum of behaviors associated with drinking. Consequently, it is unclear whether patterns of familial risk for psychopathology are directly or indirectly related to patterns of alcohol use and problems in late adolescence or mediated by behavioral characteristics, such as temperament, mood. OBJECTIVES We examined direct and indirect effects of perceived family history of psychopathology on pre-collegiate alcohol use and problems via the Transmissible Liability Index (TLI). METHODS Participants (N = 302; 29.6% male) provided self-report data on age of onset of drinking, past 90-day frequency of alcohol use and problems (AUP), family history of internalizing and alcohol and illicit substance use, and TLI. RESULTS Approximately 21% of participants reported having at least one relative with a history of regular and/or problematic alcohol use, compared to 12% for illicit substance use, and -55% for internalizing problems. Higher TLI scores were associated with increased family history of substance use, alcohol use, and internalizing problems, as well as earlier age of onset of drinking. Family history of internalizing problems was the most robust indicator of AUP (β = 0.20 [95% CI = 0.04-0.36], P = .01). Path analyses suggested that the individual-level behaviors that comprise TLI mediate the effects of family history on age of initiation and regular alcohol consumption. CONCLUSIONS Family history of internalizing, drinking, and illicit substance use reflect generalized risk for a broad set of behaviors associated with risk for alcohol initiation and use during the transition from high school to college.
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Affiliation(s)
- April L Brown
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Roberto A España
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Chelsie E Benca-Bachman
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
| | - Justine W Welsh
- Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Rohan HC Palmer
- Behavioral Genetics of Addiction Laboratory, Department of Psychology, Emory University, Atlanta, GA, USA
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Mai-Lippold SA, Dettlinger CM, Khalsa SS, Pollatos O. A Pilot Study on the Effect of an Energy Drink on Interoception in High vs. Low Anxiety Sensitivity Individuals. EUROPEAN JOURNAL OF HEALTH PSYCHOLOGY 2020. [DOI: 10.1027/2512-8442/a000061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract. Background: The market for energy drinks has grown quickly over the past 20 years. While the physiological and psychological effects of different ingredients have been studied, the influence of energy drinks on interoceptive processes is unclear. Anxiety has been associated with amplified interoceptive functioning, suggesting potentially exaggerated reactions to energy drinks. Aims: Investigate the effect of energy drink consumption and anxiety sensitivity (AS) as well as their possible interactions on cardiorespiratory dimensions of interoception. Method: Thirty-nine healthy students consumed an energy drink via a placebo-controlled, counterbalanced, crossover design. Cardiac and respiratory interoceptive accuracy (IAcc), interoceptive sensibility (IS), and interoceptive evaluation (IE) were assessed. Heartbeat-evoked potentials (HEPs) were analyzed to evaluate neural processing of the heartbeat. Results: Consumption of one energy drink did not influence IAcc, IS, or IE. However, high AS subjects reported reduced interoceptive confidence after energy drink intake. While HEP amplitudes did not differ depending on the type of drink, high AS subjects showed reduced HEPs overall compared to low AS subjects. Heart rate was significantly lower following energy drink consumption as compared to the placebo condition. Limitations: The sample size was small, energy dosages low, and physiological parameters should be assessed in more detail. Conclusion: Energy drink consumption was associated with an interoceptive bias in high AS individuals suggesting possible interaction effects between changes in physical state, interoception, and anxiety.
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Affiliation(s)
| | | | - Sahib S. Khalsa
- Laureate Institute for Brain Research, University of Tulsa, OK, USA
- Oxley College of Health Sciences, University of Tulsa, OK, USA
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Ulm University, Germany
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34
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Dong E, Pandey SC. Prenatal stress induced chromatin remodeling and risk of psychopathology in adulthood. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 156:185-215. [PMID: 33461663 PMCID: PMC7864549 DOI: 10.1016/bs.irn.2020.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
New insights into the pathophysiology of psychiatric disorders suggest the existence of a complex interplay between genetics and environment. This notion is supported by evidence suggesting that exposure to stress during pregnancy exerts profound effects on the neurodevelopment and behavior of the offspring and predisposes them to psychiatric disorders later in life. Accumulated evidence suggests that vulnerability to psychiatric disorders may result from permanent negative effects of long-term changes in synaptic plasticity due to altered epigenetic mechanisms (histone modifications and DNA methylation) that lead to condensed chromatin architecture, thereby decreasing the expression of candidate genes during early brain development. In this chapter, we have summarized the literature of clinical studies on psychiatric disorders induced by maternal stress during pregnancy. We also discussed the epigenetic alterations of gene regulations induced by prenatal stress. Because the clinical manifestations of psychiatric disorders are complex, it is obvious that the biological progression of these diseases cannot be studied only in postmortem brains of patients and the use of animal models is required. Therefore, in this chapter, we have introduced a well-established mouse model of prenatal stress (PRS) generated in restrained pregnant dams. The behavioral phenotypes of the offspring (PRS mice) born to the stressed dam and underlying epigenetic changes in key molecules related to synaptic activity were described and highlighted. PRS mice may serve as a useful model for investigating the pathogenesis of psychiatric disorders and may be a useful tool for screening for the potential compounds that may normalize aberrant epigenetic mechanisms induced by prenatal stress.
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Affiliation(s)
- Erbo Dong
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States.
| | - Subhash C Pandey
- Center for Alcohol Research in Epigenetics, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States; Jesse Brown VA Medical Center, Chicago, IL, United States
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35
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Affiliation(s)
- Dean McKay
- Department of Psychology, Fordham University, United States.
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36
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Diaz MR, Johnson JM, Varlinskaya EI. Increased ethanol intake is associated with social anxiety in offspring exposed to ethanol on gestational day 12. Behav Brain Res 2020; 393:112766. [PMID: 32535179 DOI: 10.1016/j.bbr.2020.112766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 01/21/2023]
Abstract
Prenatal alcohol exposure (PAE) can result in physical, cognitive, and neurological deficits termed Fetal Alcohol Spectrum Disorder (FASD). Deficits in social functioning associated with PAE are frequently observed and persist throughout the lifespan. Social impairments, such as social anxiety, are associated with increased alcohol abuse, which is also highly pervasive following PAE. Yet, the relationship between PAE-induced social alterations and alcohol intake later in life is not well understood. In order to test this relationship, we exposed pregnant female Sprague Dawley rats to a single instance of PAE on gestational day 12, a period of substantial neural development, and tested offspring in adulthood (postnatal day 63) in a modified social interaction test followed by alternating alone and social ethanol intake sessions. Consistent with our previous findings, we found that, in general, PAE reduced social preference (measure of social anxiety-like behavior) in female but not male adults. However, ethanol intake was significantly higher in the PAE group regardless of sex. When dividing subjects according to level of social anxiety-like behavior (low, medium, or high), PAE males (under both drinking contexts) and control females (under the social drinking context) with a high social anxiety phenotype showed the highest level of ethanol intake. Taken together, these data indicate that PAE differentially affects the interactions between social anxiety, ethanol intake, and drinking context in males and females. These findings extend our understanding of the complexity and persistence of PAE's sex-dependent effects into adulthood.
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Affiliation(s)
- Marvin R Diaz
- Department of Psychology, Center for Development and Behavioral Neuroscience Binghamton University, Binghamton, NY13902, United States; Developmental Exposure Alcohol Research Center, Baltimore MD21201, Binghamton NY 13902, Syracuse NY13210, United States.
| | - Julia M Johnson
- Developmental Exposure Alcohol Research Center, Baltimore MD21201, Binghamton NY 13902, Syracuse NY13210, United States
| | - Elena I Varlinskaya
- Department of Psychology, Center for Development and Behavioral Neuroscience Binghamton University, Binghamton, NY13902, United States; Developmental Exposure Alcohol Research Center, Baltimore MD21201, Binghamton NY 13902, Syracuse NY13210, United States
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37
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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.
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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
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38
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Kelly ME, Guillot CR, Quinn EN, Lucke HR, Bello MS, Pang RD, Leventhal AM. Anxiety sensitivity in relation to cigarette smoking and other substance use in African American smokers. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2020; 34:669-679. [PMID: 32162964 DOI: 10.1037/adb0000573] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anxiety sensitivity (AS)-fearfulness of anxiety symptoms-has been implicated in the etiology of emotional disorders (e.g., depressive and anxiety disorders) and linked to cigarette smoking and other substance use (SU). However, studies examining AS in relation to SU primarily have been conducted with racially/ethnically heterogeneous or mostly European American samples. Hence, this cross-sectional study involving secondary analysis of baseline data focused on investigating associations of AS with cigarette smoking and other SU in a sample of 630 non-treatment-seeking African American smokers (37.3% female; M age = 49.6 years; M cigarettes smoked per day = 15.4). After screening out individuals with non-nicotine substance dependence, participants reported their demographics, AS, dysphoria symptoms (i.e., depression and anxiety symptoms), and SU. In regression analyses controlling for dysphoria symptoms, age, education level, income level, and years of regular smoking, AS was positively associated with tobacco withdrawal severity (β = .12, p = .007), overall smoking motives (β = .17, p < .001), alcohol use problems (β = .12, p = .005), and other (non-nicotine, nonalcohol) SU problems (β = .16, p < .001). Though lacking the passage of time between assessments needed to provide strong evidence of mediation, unplanned analyses further revealed indirect associations of AS with several SU variables through dysphoria symptoms. Current findings are consistent with those found in prior samples and suggest that AS is similarly related to SU in African Americans, who may benefit from interventions that have been helpful in improving AS, dysphoria symptoms, and SU in other groups. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Mariel S Bello
- Department of Psychology, University of Southern California
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine
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39
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Paulus DJ, Gallagher MW, Neighbors C, Zvolensky MJ. Computer-delivered personalized feedback intervention for hazardous drinkers with elevated anxiety sensitivity: Study protocol for a randomized controlled trial. J Health Psychol 2020; 26:2349-2358. [PMID: 32126840 DOI: 10.1177/1359105320909858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Integrated treatments for hazardous drinking and anxiety/depression are virtually nonexistent. Anxiety sensitivity is a common mechanism for both anxiety/depression and hazardous drinking. This article presents a study protocol for the development and testing of an integrated remotely delivered anxiety sensitivity/hazardous drinking personalized feedback intervention. Hazardous drinking college students with elevated anxiety sensitivity (n = 130) will be randomly assigned to a single session of a novel integrated personalized feedback intervention for anxiety sensitivity/hazardous drinking or control condition. Follow-ups will occur at 1 week, 1 month, and 3 months. This study will serve as an initial test and proof of concept for an integrated anxiety sensitivity/hazardous drinking personalized feedback intervention.
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Affiliation(s)
- Daniel J Paulus
- Medical University of South Carolina, USA.,University of Houston, USA
| | | | | | - Michael J Zvolensky
- University of Houston, USA.,The University of Texas MD Anderson Cancer Center, USA
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40
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Guillot CR, Blackledge SM, Douglas ME, Cloutier RM, Liautaud MM, Pang RD, Kirkpatrick MG, Leventhal AM. Indirect Associations of Anxiety Sensitivity with Tobacco, Alcohol, and Other Drug Use Problems Through Emotional Disorder Symptoms in Adolescents. Behav Med 2020; 46:161-169. [PMID: 31039083 PMCID: PMC6821558 DOI: 10.1080/08964289.2019.1573797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Theoretically, anxiety sensitivity-fear of anxiety symptoms-enhances perception of and emotional reactivity to autonomic arousal and mental distress, thereby increasing negative affect and motivation to use substances for negative reinforcement. Because no prior study of adolescents has tested if anxiety sensitivity is indirectly associated with substance use problems through symptoms of emotional disorders (i.e., disorders involving high levels of negative affect), the current cross-sectional study examined this theoretical pathway. Participants included ninth-grade students from 10 different high schools in the Los Angeles metropolitan area (N = 3005; 54.3% female). Self-report measures of anxiety sensitivity, emotional disorder symptoms, tobacco dependence, and alcohol and other drug problems were administered. Controlling for sex, race/ethnicity, parental education, school, and impulsiveness, we tested the associations of anxiety sensitivity with tobacco, alcohol, and other drug use problems as well as the indirect effects of anxiety sensitivity on each domain of substance use problems through emotional disorder symptoms. Anxiety sensitivity was associated with more severe tobacco dependence and greater alcohol problems and other drug problems, and anxiety sensitivity further was indirectly associated with all three domains of substance use problems through emotional disorder symptoms. Current findings suggest that adolescents high in anxiety sensitivity tend to experience emotional disorder symptoms, which may increase risk for substance use problems. Interventions that target anxiety sensitivity and enhance negative-affect coping skills may assist in preventing and reducing adolescent substance use problems.
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Affiliation(s)
- Casey R. Guillot
- Department of Psychology, University of North Texas, Denton, TX,Corresponding author: Casey Guillot, PhD, University of North Texas, Department of Psychology, 1155 Union Circle #311280, Denton, TX 76203-5017; Tel: 1-940-369-8426; Fax: 1-940-565-4682;
| | - Sabrina M. Blackledge
- Department of Psychiatry, The University of Texas Health Science Center at San Antonio
| | | | | | - Madalyn M. Liautaud
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | - Raina D. Pang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA
| | | | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA,Department of Psychology, University of California, Los Angeles, CA
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41
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Beard C, Peckham AD, Griffin ML, Weiss RD, Taghian N, McHugh RK. Associations among interpretation bias, craving, and abstinence self-efficacy in adults with substance use disorders. Drug Alcohol Depend 2019; 205:107644. [PMID: 31698320 PMCID: PMC7015577 DOI: 10.1016/j.drugalcdep.2019.107644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Interpretation bias is a crucial therapeutic target in emotional disorders. However, few studies have examined the role of interpretation bias in substance use disorders (SUDs). Our specific aims were: (1) to examine whether interpretation bias was associated with craving and abstinence self-efficacy, and (2) explore potential moderators of these associations, including anxiety severity, sex, and substance type. METHODS Adults attending an inpatient SUD treatment program (N = 224; mean age = 38.95; 67% male/33% female; 68% primary alcohol use disorder/29% primary opioid use disorder) completed the Word-Sentence Association Paradigm (WSAP) with ambiguous situations related to general anxiety domains (e.g., daily stress, health, relationships), as well as measures of craving (Craving Scale), abstinence self-efficacy (Brief Situational Confidence Scale), and anxiety symptoms (Overall Anxiety Severity and Impairment Scale [OASIS] and Anxiety Sensitivity Index-3). RESULTS Negative interpretation bias was modestly associated with more craving (r = .23, p = .001) and less confidence to resist using substances (r = -0.23, p = .001). In multiple linear regression models that included the anxiety measures, interpretation bias was the most robust predictor of craving and abstinence self-efficacy. Sex (N = 224) and substance type (opioid vs. alcohol; n = 219) did not moderate these relationships. CONCLUSIONS These findings suggest that interpretation bias might be an important individual difference within SUD populations.
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Affiliation(s)
- Courtney Beard
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States.
| | - Andrew D. Peckham
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Margaret L. Griffin
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States,Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, United States
| | - Roger D. Weiss
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States,Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, United States
| | - Nadine Taghian
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, United States
| | - R. Kathryn McHugh
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States,Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, MA, United States
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Foroughi AA, Mohammadpour M, Khanjani S, Pouyanfard S, Dorouie N, Parvizi Fard AA. Psychometric properties of the Iranian version of the Anxiety Sensitivity Index-3 (ASI-3). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:254-261. [PMID: 31644692 DOI: 10.1590/2237-6089-2018-0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/07/2019] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Anxiety sensitivity plays a prominent role in the etiology of anxiety disorders. This construct has attracted widespread interest from experts and researchers. The Anxiety Sensitivity Index (ASI-3) is the most common scale for measuring anxiety sensitivity. OBJECTIVE To analyze the psychometric properties and factor structure of the ASI-3 in Iranian student samples. METHODS 220 students (135 women, 85 men) from Kermanshah University of Medical Sciences were selected by the convenience sampling method to evaluate the psychometric properties and analyze the factor structure of the ASI-3. The subjects were also asked to complete the Acceptance and Action Questionnaire-II (AAQ-II), Whiteley Index, Intolerance of Uncertainty, and Neuroticism scales. LISREL and SPSS were used to analyze the data. Cronbach's alpha and correlation coefficients were calculated and confirmatory factor analysis was conducted. RESULTS The results of the confirmatory factor analysis revealed a three-factor structure with physical, cognitive, and social components (comparative fit index = 0.94; normed fit index = 0.91; root mean square error of approximation = 0.09). The ASI-3 had positive and significant correlations with health anxiety (0.59), intolerance of uncertainty (0.29), and neuroticism (0.51). Furthermore, the ASI-3 had a negative and significant correlation with the AAQII (-0.58). Cronbach's alpha coefficients for the whole scale and for the physical, cognitive, and social concerns factors were 0.90, 0.74, 0.79, and 0.78, respectively. The invariance of the index was significant compared to the original English version. CONCLUSION In general, the results support the adequacy of the psychometric properties of the Persian version of the ASI-3. Theoretical and applied implications will be discussed.
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Affiliation(s)
- Ali Akbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohsen Mohammadpour
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sajad Khanjani
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Tehran Psychiatric Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Pouyanfard
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nadia Dorouie
- Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Parvizi Fard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Perkins AE, Varlinskaya EI, Deak T. From adolescence to late aging: A comprehensive review of social behavior, alcohol, and neuroinflammation across the lifespan. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 148:231-303. [PMID: 31733665 DOI: 10.1016/bs.irn.2019.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The passage of time dictates the pace at which humans and other organisms age but falls short of providing a complete portrait of how environmental, lifestyle and underlying biological processes contribute to senescence. Two fundamental features of the human experience that change dramatically across the lifespan include social interactions and, for many, patterns of alcohol consumption. Rodent models show great utility for understanding complex interactions among aging, social behavior and alcohol use and abuse, yet little is known about the neural changes in late aging that contribute to the natural decline in social behavior. Here, we posit that aging-related neuroinflammation contributes to the insipid loss of social motivation across the lifespan, an effect that is exacerbated by patterns of repeated alcohol consumption observed in many individuals. We provide a comprehensive review of (i) neural substrates crucial for the expression of social behavior under non-pathological conditions; (ii) unique developmental/lifespan vulnerabilities that may contribute to the divergent effects of low-and high-dose alcohol exposure; and (iii) aging-associated changes in neuroinflammation that may sit at the intersection between social processes and alcohol exposure. In doing so, we provide an overview of correspondence between lifespan/developmental periods between common rodent models and humans, give careful consideration to model systems used to aptly probe social behavior, identify points of coherence between human and animal models, and point toward a multitude of unresolved issues that should be addressed in future studies. Together, the combination of low-dose and high-dose alcohol effects serve to disrupt the normal development and maintenance of social relationships, which are critical for both healthy aging and quality of life across the lifespan. Thus, a more complete understanding of neural systems-including neuroinflammatory processes-which contribute to alcohol-induced changes in social behavior will provide novel opportunities and targets for promoting healthy aging.
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Affiliation(s)
- Amy E Perkins
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University-SUNY, Binghamton, NY, United States
| | - Elena I Varlinskaya
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University-SUNY, Binghamton, NY, United States
| | - Terrence Deak
- Developmental Exposure Alcohol Research Center, Behavioral Neuroscience Program, Department of Psychology, Binghamton University-SUNY, Binghamton, NY, United States.
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Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies. Addiction 2019; 114:968-982. [PMID: 30891835 PMCID: PMC6563455 DOI: 10.1111/add.14575] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings. DESIGN AND SETTING We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later. PARTICIPANTS Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years. MEASUREMENTS Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders). FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87). CONCLUSIONS Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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Hudiburgh SE, Shaw AM, Arditte Hall KA, Timpano KR. Anxiety Sensitivity Differentially Predicts Factors of Interpersonal-Psychological Suicide Risk: A Consideration of Specificity. Suicide Life Threat Behav 2019; 49:264-277. [PMID: 29108113 DOI: 10.1111/sltb.12421] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 09/07/2017] [Indexed: 11/28/2022]
Abstract
Recent studies have identified anxiety sensitivity (AS) as a risk factor for suicidality; however, limited work has been performed to understand this risk within the context of the interpersonal-psychological theory of suicide (IPTS; Joiner, 2005). The current study examined the relationship between overall AS, each AS subfactor (cognitive, social, and physical), and the three IPTS domains (perceived burdensomeness, thwarted belongingness, and acquired capability). While each AS subfactor uniquely predicted one IPTS domain, greater overall AS only predicted greater acquired capability, suggesting that assessment of AS at the subfactor level may offer us more information about an individual's interpersonal suicide risk.
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Affiliation(s)
| | | | - Kimberly A Arditte Hall
- National Center for PTSD/VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Paulus DJ, Gallagher MW, Raines AM, Schmidt NB, Zvolensky MJ. Intraindividual change in anxiety sensitivity and alcohol use severity 12-months following smoking cessation treatment. Behav Res Ther 2019; 116:10-18. [PMID: 30731131 DOI: 10.1016/j.brat.2019.01.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/27/2018] [Accepted: 01/29/2019] [Indexed: 12/14/2022]
Abstract
Although past work has documented reduction in alcohol use severity among smokers following smoking cessation treatment, little is known regarding factors associated with this reduction. The current study sought to examine relations between trajectories of change in anxiety sensitivity and non-targeted alcohol use severity from baseline to one year following smoking cessation treatment. Individuals (n = 386) were adult daily smokers engaged in a smoking cessation treatment study. Measures of alcohol use severity and anxiety sensitivity were collected at baseline as well as 1-, 3-, 6-, and 12-months post-treatment. Latent growth curve modelling was used to estimate intercepts and slopes. Anxiety sensitivity (M = -0.87 95% CI [-1.19, -0.54], p < 0.001) and alcohol use severity (M = -0.22 95% CI [-0.38, -0.06], p = 0.006) each significantly reduced over time. Reductions in anxiety sensitivity were strongly associated with reductions in alcohol use over time (r = 0.63, 95% CI [0.18, 1.09], p = 0.006). Changes in anxiety sensitivity positively correlated with changes in alcohol use severity. Examinations of means suggest that anxiety sensitivity reduced earlier whereas alcohol use severity reduced later in the follow-up period. If replicated establishing temporal precedence of change, these results could implicate anxiety sensitivity reduction as one avenue towards reduced alcohol use severity, among smokers.
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Affiliation(s)
- Daniel J Paulus
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; University of Houston, Department of Psychology, Houston, TX, USA.
| | - Matthew W Gallagher
- University of Houston, Department of Psychology, Houston, TX, USA; University of Houston, Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
| | | | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, USA; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, USA; Health Institute, University of Houston, Houston, TX, USA.
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Reaves DL, Christiansen P, Boyland EJ, Halford JCG, Llewellyn CH, Hardman CA. Modeling the Distinct Negative-Reinforcement Mechanisms Associated with Alcohol Misuse and Unhealthy Snacking. Subst Use Misuse 2019; 54:921-933. [PMID: 30753102 DOI: 10.1080/10826084.2018.1552299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Negative personality characteristics have been implicated in promoting overconsumption of both alcohol and food. Furthermore, positive motivations (enhancement) and negative motivations (coping) may mediate the association between personality and alcohol or food (over)consumption. OBJECTIVES This study hypothesized that i.) drinking to cope and ii.) eating to cope would mediate the association between hopelessness/anxiety sensitivity and hazardous drinking/unhealthy snacking, respectively, and iii.) eating and drinking to cope would represent separate strategies. METHODS Participants were recruited via opportunity sampling through university schemes, social media, email and web page advertisements. Questionnaires included the Alcohol Use Disorders Identification Test, Substance Use Risk Profile Scale, Modified Drinking Motives Questionnaire Short Form, Palatable Eating Motives Scale and Snack/Meal Food Intake Measure. RESULTS Participants were 198 undergraduates, weight-related research volunteers and the public (83% female; 90% university educated). The hypothesized structural model fit the data well. As predicted, there were significant indirect associations between negative personality characteristics, hazardous drinking and unhealthy snacking via coping; specifically, individuals higher in anxiety sensitivity/hopelessness used food or alcohol to cope which, in turn, significantly predicted unhealthy snacking, and hazardous drinking, respectively. Importantly, drinking and eating to cope represented outcome-specific strategies, indicated by no significant association between eating to cope and hazardous drinking, or between drinking to cope and snacking. CONCLUSIONS This study demonstrates that coping motivations are critical to the relationship between negative personality characteristics and unhealthy behaviors and highlights the distinct negative-reinforcement pathways associated with hazardous drinking and unhealthy snacking in majority university-educated females from the UK.
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Affiliation(s)
- Danielle L Reaves
- a Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Paul Christiansen
- a Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Emma J Boyland
- a Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Jason C G Halford
- a Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Clare H Llewellyn
- b Department of Behavioural Science and Health, University College London, London, UK
| | - Charlotte A Hardman
- a Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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Arnau-Soler A, Adams MJ, Hayward C, Thomson PA. Genome-wide interaction study of a proxy for stress-sensitivity and its prediction of major depressive disorder. PLoS One 2018; 13:e0209160. [PMID: 30571770 PMCID: PMC6301766 DOI: 10.1371/journal.pone.0209160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/02/2018] [Indexed: 01/31/2023] Open
Abstract
Individual response to stress is correlated with neuroticism and is an important predictor of both neuroticism and the onset of major depressive disorder (MDD). Identification of the genetics underpinning individual differences in response to negative events (stress-sensitivity) may improve our understanding of the molecular pathways involved, and its association with stress-related illnesses. We sought to generate a proxy for stress-sensitivity through modelling the interaction between SNP allele and MDD status on neuroticism score in order to identify genetic variants that contribute to the higher neuroticism seen in individuals with a lifetime diagnosis of depression compared to unaffected individuals. Meta-analysis of genome-wide interaction studies (GWIS) in UK Biobank (N = 23,092) and Generation Scotland: Scottish Family Health Study (N = 7,155) identified no genome-wide significance SNP interactions. However, gene-based tests identified a genome-wide significant gene, ZNF366, a negative regulator of glucocorticoid receptor function implicated in alcohol dependence (p = 1.48x10-7; Bonferroni-corrected significance threshold p < 2.79x10-6). Using summary statistics from the stress-sensitivity term of the GWIS, SNP heritability for stress-sensitivity was estimated at 5.0%. In models fitting polygenic risk scores of both MDD and neuroticism derived from independent GWAS, we show that polygenic risk scores derived from the UK Biobank stress-sensitivity GWIS significantly improved the prediction of MDD in Generation Scotland. This study may improve interpretation of larger genome-wide association studies of MDD and other stress-related illnesses, and the understanding of the etiological mechanisms underpinning stress-sensitivity.
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Affiliation(s)
- Aleix Arnau-Soler
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J. Adams
- Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, United Kingdom
| | | | | | - Caroline Hayward
- Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Pippa A. Thomson
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Bartel SJ, Sherry SB, Smith MM, Vidovic VV, Stewart SH. Is anxiety sensitivity a risk factor for, or complication of, alcohol misuse? A meta-analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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50
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Chaotic-Enmeshment and Anxiety: The Mediating Role of Psychological Flexibility and Self-Compassion. CONTEMPORARY FAMILY THERAPY 2018. [DOI: 10.1007/s10591-018-9461-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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