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Bocci Benucci S, Di Gesto C, Ghinassi S, Casale S, Fioravanti G. Pornography use, problematic pornography use, impulsivity, and sensation seeking: a meta-analysis. J Sex Med 2024:qdae101. [PMID: 39183145 DOI: 10.1093/jsxmed/qdae101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/20/2024] [Accepted: 07/30/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND While some individuals engage in recreational pornography use (PU), others may develop an uncontrolled pattern of use termed problematic pornography use (PPU). PPU is characterized by persistent, excessive, or compulsive engagement with pornographic content, despite distress and adverse consequences. Impulsivity has been identified as a factor associated with PU and PPU. AIM The present meta-analysis aims to sum up the existing research on the relationship between impulsivity and PU/PPU and investigate whether age and gender could moderate this relationship. METHODS A keyword-based systematic literature search was performed to identify articles that assessed PU/PPU and impulsivity. Extracted correlations were converted into Fisher's Z. Meta-regression analyses were also performed. Publication bias was assessed by Egger's regression intercept. OUTCOMES Outcomes included general impulsivity and its dimensions (ie, negative and positive urgency, lack of premeditation and perseverance), sensation seeking, PU, and PPU. RESULTS Meta-analytic results of the random effects model showed a significant positive correlation between impulsivity as total score and PU (n = 1504, k = 4, Fisher's Z = 0.21, P < .001) and PPU (n = 20174, k = 13, Fisher's Z = 0.17, P < .001). Significant and positive associations were also found between sensation seeking and PU (n = 11707, k = 11, Fisher's Z = 0.14, P < .001) and PPU (n = 20152, k = 9, Fisher's Z = 0.06, P < .001). Concerning the relationship between PPU and different dimensions of impulsivity, almost all the associations were significant and positive. The dimension of positive urgency and attentional and nonplanning impulsivity showed the strongest association. Age (β = -0.50, Q = 101.26, df = 11, P < .001) and gender (female = 1; β = -0.46, Q = 102.54, df = 12, P < .001) moderated the association between general impulsivity and PPU. No risk of publication bias emerged. CLINICAL IMPLICATIONS Prevention programs of PPU should focus on impulsivity and certain key dimensions (eg, positive urgency, attentional and nonplanning impulsivity) and be tailored to individual impulsivity profiles, considering age and gender differences. STRENGTHS AND LIMITATIONS The primary strength of this meta-analysis is that it considers various conceptualizations of impulsivity. However, the results are to be interpreted with caution since >30% of relevant studies had to be excluded because information could not be gathered from the study authors. CONCLUSION These results suggest that general impulsivity is linked to PU and PPU and that specific dimensions of impulsivity (ie, attentional impulsivity, nonplanning impulsivity, and positive urgency) can serve as risk factors for PPU.
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Affiliation(s)
- Sara Bocci Benucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Cristian Di Gesto
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, 50135, Italy
| | - Simon Ghinassi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, 50134, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, 50135, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, 50135, Italy
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Holmes SC, Zare M, Haeny AM, Williams MT. Racial Stress, Racial Trauma, and Evidence-Based Strategies for Coping and Empowerment. Annu Rev Clin Psychol 2024; 20:77-95. [PMID: 38346289 DOI: 10.1146/annurev-clinpsy-081122-020235] [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] [Indexed: 02/15/2024]
Abstract
Racial stress and racial trauma refer to psychological, physiological, and behavioral responses to race-based threats and discriminatory experiences. This article reviews the evidence base regarding techniques for coping with racial stress and trauma. These techniques include self-care, self-compassion, social support, mindfulness, cognitive restructuring, cognitive defusion, identity-affirming practices and development of racial/ethnic identity, expressive writing, social action and activism, and psychedelics. These strategies have shown the potential to mitigate psychological symptoms and foster a sense of empowerment among individuals affected by racial stress and trauma. While the ultimate goal should undoubtedly be to address the root cause of racism, it is imperative to acknowledge that until then, implementing these strategies can effectively provide much-needed support for individuals affected by racism.
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Affiliation(s)
- Samantha C Holmes
- Department of Psychology, College of Staten Island, City University of New York, New York, NY, USA;
| | - Manzar Zare
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; ,
| | - Angela M Haeny
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA;
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Woods-Gonzalez R, Waddell JT, King SE, Corbin WR. Differentiating action from inaction: Longitudinal relations among impulsive personality traits, internalizing symptoms, and drinking behavior. Addict Behav 2024; 154:108019. [PMID: 38502991 PMCID: PMC11015960 DOI: 10.1016/j.addbeh.2024.108019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/27/2024] [Accepted: 03/15/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Impulsive personality traits are strong, consistent risk factors for heavy drinking, and modern theories suggest that impulsive traits may also confer risk for internalizing symptoms. However, it remains unclear which specific impulsive traits are linked with heavy drinking versus internalizing symptoms, and whether heavy drinking and internalizing symptoms are mechanisms of risk for negative alcohol consequences in impulsive individuals. METHOD Data are from a longitudinal study of young adults (N = 448, Mage = 22.27, 43.5 % female) assessed at baseline (T1), 6 months (T2), and one year later (T3). Longitudinal path models tested whether T1 impulsive traits (i.e., lack of premeditation, lack of perseverance, sensation seeking, positive urgency, negative urgency) were indirectly associated with T3 negative alcohol consequences through heavy T2 drinking and T2 internalizing symptoms (i.e., depression, anxiety, stress). Separate models were tested for positive and negative urgency given strong correlations between these measures. RESULTS Across models, T1 lack of premeditation indirectly predicted more T3 negative alcohol consequences through heavy T2 drinking. When tested separately, T1 negative urgency indirectly predicted more T3 negative consequences through higher T2 stress and depressive (but not anxiety) symptoms, and T1 positive urgency predicted higher T2 anxiety symptoms, but T2 anxiety was unrelated to T3 negative consequences. Across models, T1 sensation seeking indirectly predicted less T3 negative consequences through decreased T2 depression. CONCLUSIONS Distinct impulsive traits prospectively predicted heavy drinking and internalizing symptoms, both of which conferred risk for negative alcohol consequences. Findings underscore the importance of targeted interventions based on personality and suggest that decreases in drinking may be more effective prevention for those who lack premeditation, whereas decreases in internalizing, particularly depression/stress, may be critical for those high in negative urgency.
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Affiliation(s)
- Ricardo Woods-Gonzalez
- Arizona State University, Department of Psychology, 900 S McAllister, Tempe, AZ 85287-1104, USA
| | - Jack T Waddell
- Arizona State University, Department of Psychology, 900 S McAllister, Tempe, AZ 85287-1104, USA.
| | - Scott E King
- Arizona State University, Department of Psychology, 900 S McAllister, Tempe, AZ 85287-1104, USA
| | - William R Corbin
- Arizona State University, Department of Psychology, 900 S McAllister, Tempe, AZ 85287-1104, USA
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Burns C, Hejl C, Z. Szabo Y. Childhood Adversity and Adult Inflammation: Exploring the Mediating Role of Emotion Regulation in the MIDUS II Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:319-334. [PMID: 38938945 PMCID: PMC11199436 DOI: 10.1007/s40653-023-00594-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 06/29/2024]
Abstract
The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00594-2.
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Affiliation(s)
- Christina Burns
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
- Department of Education, Health, & Behavior, University of North Dakota, Grand Forks, ND USA
| | - Christina Hejl
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
| | - Yvette Z. Szabo
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX USA
- Department of Psychology, California State University, Los Angeles, Los Angeles, CA USA
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Teh WL, Si SY, Liu J, Subramaniam M, Ho R. The clinical significance of emotional urgency in bipolar disorder: a scoping review. BMC Psychol 2024; 12:273. [PMID: 38750587 PMCID: PMC11097479 DOI: 10.1186/s40359-024-01700-1] [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: 02/09/2024] [Accepted: 04/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Emotional urgency, defined as a trait concept of emotion-based impulsivity, is at least moderately associated with general psychopathology. However, its clinical significance and associations with clinically relevant features of bipolar disorder remain unclear. This scoping review aims address this gap by determining the extent of evidence in this niche scope of study. METHODS Evidence of between-group differences of positive and negative urgency, its associations with mood severity, and all peripheral associations related to illness and psychosocial outcomes were synthesized based on PRISMA checklists and guidelines for scoping reviews (PRISMA-ScR). DESIGN Electronic databases were searched for articles published between January 2001 and January 2024. A total of 1013 entries were gathered, and a total of 10 articles were included in the final selection after the removal of duplicates and ineligible articles. RESULTS Differences in urgency scores between bipolar disorder and healthy controls were large (Cohen's d ranged from 1.77 to 2.20). Negative urgency was at least moderately associated with overall trauma, emotional abuse, neglect, suicide ideation, neuroticism, and irritable/cyclothymic temperament, whereas positive urgency was at least moderately associated with various aspects of aggression and quality of life. Positive but not negative urgency was associated with quality of life in bipolar disorder. CONCLUSION Large between-group differences found for emotional urgency in bipolar disorder imply large clinical significance. Emotional urgency was associated with worse clinical features and outcomes. Given the high clinical heterogeneity of the disorder, emotional urgency may be an important phenotype indicative of greater disorder severity.
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Affiliation(s)
- Wen Lin Teh
- Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore, S539747, Singapore.
- Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, S119077, Singapore.
| | - Sheng Yeow Si
- MOH Holdings, 1 Maritime Square, #11-25, Singapore, S099253, Singapore
| | - Jianlin Liu
- Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore, S539747, Singapore
| | - Mythily Subramaniam
- Institute of Mental Health, 10 Buangkok View, Buangkok Green, Medical Park, Singapore, S539747, Singapore
| | - Roger Ho
- Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, S119077, Singapore
- Institute of Health Innovation and Technology (iHealthtech), National University of Singapore, 14 Medical Dr, #14-01 MD6, Singapore, S117599, Singapore
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Waddell JT, Sternberg A, Eisenberg N, Chassin L. Longitudinal Relations Among Parental Substance Use Disorder and Adolescent Drinking Behavior: The Role of Temperament, Negative Urgency, and Maternal Parenting. J Youth Adolesc 2024; 53:833-848. [PMID: 37864729 PMCID: PMC11232500 DOI: 10.1007/s10964-023-01886-4] [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: 07/23/2023] [Accepted: 10/10/2023] [Indexed: 10/23/2023]
Abstract
Research suggests that parental substance use disorder is associated with adolescent drinking indirectly through negative urgency, a form of impulsivity that is particularly associated with high-risk drinking. Moreover, childhood mechanisms of risk may play a role in this developmental chain such that childhood temperament and parenting may be mechanisms through which parental substance use disorder is associated with adolescent negative urgency and drinking behavior. Therefore, the current study tested whether parental substance use disorder was indirectly associated with adolescent drinking frequency through childhood temperament (i.e., "dysregulated irritability") and adolescent negative urgency, and whether relations differed by levels of maternal support and consistency of discipline. Data come from a multigenerational, longitudinal study of familial substance use disorder (N = 276, Mage in childhood = 6.28 (SD = 1.16), Mage in adolescence = 15.86 (SD = 1.56), 45.3% female). Findings indicated that parental substance use disorder indirectly predicted adolescent drinking through both childhood dysregulated irritability and adolescent negative urgency (mediated pathways). This indirect relation was stronger at higher vs. lower levels of maternal support but did not vary by maternal consistency of discipline. Parental substance use disorder also indirectly predicted adolescent drinking separately through childhood dysregulated irritability and negative urgency. Findings thus suggest that childhood dysregulated irritability may be an early marker of risk toward high-risk personality traits and behavior in adolescence that are associated with having a parental history of substance use disorder. Findings also suggest that increased maternal support may only be helpful in buffering risk for those with low levels of dysregulated irritability. Prevention efforts focused on childhood emotion regulation and emotion-based action may be useful in preventing adolescent risk behavior.
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Affiliation(s)
- Jack T Waddell
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, USA.
| | | | - Nancy Eisenberg
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, USA
| | - Laurie Chassin
- Department of Psychology, Arizona State University, Tempe, AZ, 85287-1104, USA
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Harvey LJ, White FA, Hunt C, Abbott M. Investigating the efficacy of a Dialectical behaviour therapy-based universal intervention on adolescent social and emotional well-being outcomes. Behav Res Ther 2023; 169:104408. [PMID: 37804543 DOI: 10.1016/j.brat.2023.104408] [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: 10/08/2022] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
There is increasing research interest as to whether Dialectical Behaviour Therapy (DBT), specifically the group skills training component, is an effective early intervention approach when delivered universally in schools. The current study aimed to provide the first large-scale examination of a universal DBT-based intervention and to also determine the extent to which home practice of DBT skills predicted changes in social and emotional outcomes over time. A non-randomised controlled trial design was employed whereby 1071 participants (51.30% Male; M age = 13.48 years) completed either an adapted eight-session DBT skills-training intervention ('WISE Teens) (n = 563) or class-as-per-usual (n = 508). On average, the 'WISE Teens' intervention did not improve outcomes with significant deteriorations or null effects observed across outcomes relative to class-as-per-usual immediately post-intervention. The largest deteriorations were observed for depressive (d = -0.22; 95% CI = -0.35, -0.08) and anxiety symptoms (d = -0.28; 95%CI - = -0.41, -0.14). Applying Bonferroni corrections, most group differences in outcomes had dissipated at follow-up, however, 'WISE Teens' participants continued to report significantly poorer quality of parent-child relationships relative to control (d = .16 for mother (95% CI = 0.01, 0.31); d = 0.17 for father (95% CI = 0.02, 0.33). While home practice was modest on average, further exploratory analyses nevertheless revealed that greater home practice was generally associated with more positive outcomes both immediately post-intervention and at follow-up. Based on these findings, the DBT-based 'WISE Teens' intervention is not recommended in its current format for universal dissemination amongst early adolescents in schools. Further research is needed to determine how to improve engagement and feasibility of delivery of DBT-based interventions universally in this context.
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Affiliation(s)
- Lauren J Harvey
- School of Psychology, University of Sydney, Camperdown, NSW, 2050, Australia.
| | - Fiona A White
- School of Psychology, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Caroline Hunt
- School of Psychology, University of Sydney, Camperdown, NSW, 2050, Australia
| | - Maree Abbott
- School of Psychology, University of Sydney, Camperdown, NSW, 2050, Australia
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Lanfredi M, Dagani J, Geviti A, Di Cosimo F, Bussolati M, Rillosi L, Albini D, Pizzi M, Ghidoni R, Fazzi E, Vita A, Rossi R. Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic. Child Adolesc Psychiatry Ment Health 2023; 17:78. [PMID: 37365640 DOI: 10.1186/s13034-023-00615-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/15/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND It is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people's mental health status during the fourth wave of the pandemic. METHODS This study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14-25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students' mental health profiles. RESULTS Overall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students' profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships. CONCLUSIONS The results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Jessica Dagani
- SIPEC Foundation, Brescia, Italy
- Department of Clinical and Experimental Sciences, Section of Clinical and Dynamic Psychology, University of Brescia, Brescia, Italy
| | - Andrea Geviti
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federica Di Cosimo
- USR Lombardia, Ufficio IV Ambito Territoriale di Brescia, Brescia, Italy
| | | | | | | | - Marina Pizzi
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Roberta Ghidoni
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Fazzi
- Child Neurology and Psychiatry Unit, Spedali Civili Hospital, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, Spedali Civili Hospital, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
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Hermosillo-de-la-Torre AE, Arteaga-de-Luna SM, Arenas-Landgrave P, González-Forteza C, Acevedo-Rojas DL, Martínez KI, Rivera-Heredia ME. DBT-PAHSE Intervention for Reduce Emotion Dysregulation and Suicide Behavior in Mexican Early Adolescents: A Longitudinal Study. Healthcare (Basel) 2023; 11:healthcare11091311. [PMID: 37174853 PMCID: PMC10177943 DOI: 10.3390/healthcare11091311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
This study aimed to evaluate the effect of time on suicidal behavior, associated risk factors, and protective factors in early Mexican adolescents. Method: With a two-year longitudinal design, which included 18 of 34 adolescents who had previously participated in a DBT skills training program (DBT-PAHSE). The study evaluated ideation, suicide attempt, depression, emotional dysregulation, and psychological resources. Results: We observed differentiating significant differences over time in emotional dysregulation (F = 2.36 p = 0.04, η2= 0.12, β = 0.72), affective resources (F = 3.94, p = 0.01, η2 = 0.18, β = 0.82), and suicidal ideation. (F = 2.55, p = 0.03, η2= 0.13, β = 0.77). In conclusion, the DBT-PAHSE program prevented deaths by suicide. It showed a reduction in emotional dysregulation up to two years after the end of treatment and maintained an increase in emotional and social resources. However, improvements are required to reduce depression over time and strengthen psychological resources.
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Affiliation(s)
- Alicia E Hermosillo-de-la-Torre
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - Stephania M Arteaga-de-Luna
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | | | | | - Denise L Acevedo-Rojas
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - Kalina I Martínez
- Psychology Department, Center for Social Sciences and Humanities of The Autonomous University of Aguascalientes, Aguascalientes 20100, Mexico
| | - María E Rivera-Heredia
- Psychology Faculty, Michoacan University of San Nicolás de Hidalgo, Morelia 58110, Mexico
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Muñoz-Martínez AM, Gómez Y, Naismith I, González-Rodríguez D. Implementation of a brief online skills group of dialectical behaviour therapy for emotional dysregulation in Latinx: a withdrawal experimental single-case design. Behav Cogn Psychother 2023:1-16. [DOI: 10.1017/s1352465823000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Abstract
Background:
Dialectical behaviour therapy (DBT) skills groups have shown promise as an effective treatment for clients with emotional dysregulation, especially when combined with individual DBT. However, their efficacy is not well established as an online therapy, or in the Latinx population.
Aims:
This study aimed to explore satisfaction, retention and effects of an internet-based DBT group added to individual online sessions.
Method:
An ABAB withdrawal experimental single-case design was conducted to evaluate the effect of a brief online DBT skills group on emotional dysregulation, anxiety and depression for five Latinx participants. DBT skills group (phase B) were compared with placebo group sessions (phase A) and fortnightly individual DBT sessions were offered throughout to manage risk.
Results:
Visual inspection showed a decrease in level of emotional dysregulation and a large effect size according to the Nonoverlap of All Pairs when comparing group DBT and placebo phases. Although depression symptoms decreased after introducing group DBT, anxiety indicators decreased most during the second round of group placebo sessions.
Discussion:
Whilst only a pilot, this study suggests that online group DBT in Latinx populations is feasible and effective for changing emotional regulation processes but may not effectively target anxiety. Future research might increase the number of DBT sessions in order to enhance learning opportunities and generalization. Replication with larger sample sizes and diverse modalities is needed.
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Anvar S, Swerdlow BA, Jobes D, Timpano KR, Mandel AA, Kleiman E, Joiner T, Johnson SL. Emotion-related impulsivity and suicidal ideation: Towards a more specific model. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:1219-1235. [PMID: 35912940 PMCID: PMC9560962 DOI: 10.1111/bjc.12383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/22/2022] [Accepted: 07/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Suicidal ideation is a pervasive and painful experience that varies considerably in its phenomenology. Here, we consider how one key risk variable might inform our understanding of variation in suicidal ideation: emotion-related impulsivity, the trait-like tendency towards unconstrained speech, behaviour, and cognition in the face of intense emotions. We hypothesized that emotion-related impulsivity would be tied to specific features, including severity, perceived lack of controllability, more rapidly fluctuating course, higher scores on a measure of acute suicidal affective disturbance, and more emotional and cognitive disturbance as antecedents. METHODS We recruited two samples of adults (Ns = 421, 221) through Amazon Mechanical Turk (MTurk), with oversampling of those with suicidal ideation. Both samples completed psychometrically sound self-report measures online to assess emotion- and non-emotion-related dimensions of impulsivity and characteristics of suicidal ideation. RESULTS One form of emotion-related impulsivity related to the severity, uncontrollability, dynamic course, and affective and cognitive precursors of ideation. CONCLUSIONS Despite limitations of the cross-sectional design and self-report measures, the current findings highlight the importance of specificity in considering key dimensions of impulsivity and suicidal ideation.
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Affiliation(s)
- Sarah Anvar
- University of California, Berkeley, California, USA
| | | | - David Jobes
- American University, Washington, District of Columbia, USA
| | | | | | - Evan Kleiman
- Rutgers University, New Brunswick, New Jersey, USA
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Whitt ZT, Sturgeon T, Rattermann MJ, Salyers M, Zapolski T, Cyders MA. Mapping recovery: A qualitative node map approach to understanding factors proximal to relapse among adolescents in a recovery high school. J Subst Abuse Treat 2022; 138:108750. [DOI: 10.1016/j.jsat.2022.108750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/14/2021] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
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Waddell JT, Elam KK, Chassin L. Multidimensional Impulsive Personality Traits Mediate the Effect of Parent Substance Use Disorder on Adolescent Alcohol and Cannabis Use. J Youth Adolesc 2022; 51:348-360. [PMID: 35048255 DOI: 10.1007/s10964-021-01556-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 12/08/2021] [Indexed: 12/22/2022]
Abstract
Theory suggests that behavioral undercontrol mediates the effect of parental substance disorder on offspring substance use, but no studies have tested multidimensional impulsive personality traits as mechanisms of risk. Adolescents (N = 392; 48% female) from a multigenerational study of familial alcohol disorder self-reported impulsive personality traits via the UPPS-P (Mage = 16.09; Range = 13-19) and alcohol/cannabis frequency one year later. The UPPS-P assesses negative and positive urgency (i.e., rash action in a negative or positive mood state), lack of premeditation (i.e., lack of planning/forethought), lack of perseverance (i.e., inability to finish tedious/boring tasks), and sensation seeking (i.e., thrill seeking/risk taking). Parent substance disorder was assessed via diagnostic interviews. Two-part hurdle models tested predictors of any substance use (i.e., binary part) and frequency of use (i.e., continuous part). Parent substance disorder was indirectly associated with any alcohol/cannabis use (binary part) and higher cannabis frequency (continuous part) through negative urgency. Parental substance disorder was associated with higher alcohol frequency through a lack of premeditation. Sensation seeking was associated with any alcohol/cannabis use but unrelated to parental substance disorder. Despite indirect effects, strong effects of parental substance disorder on substance use remained. The findings are discussed in terms of theory and public health implications.
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Affiliation(s)
| | - Kit K Elam
- Indiana University, Bloomington, IN, USA
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14
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Pedrini L, Rossi R, Magni LR, Lanfredi M, Meloni S, Ferrari C, Macis A, Lopizzo N, Zonca V, Cattaneo A. Emotional Regulation in Teens and Improvement of Constructive Skills (EmoTIConS): study protocol for a randomized controlled trial. Trials 2021; 22:920. [PMID: 34906222 PMCID: PMC8670183 DOI: 10.1186/s13063-021-05886-2] [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: 05/19/2021] [Accepted: 11/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emotional dysregulation (ED) constitutes a relevant factor involved in the onset and maintenance of many mental disorders. Targeting ED during adolescence could be a determinant both to identify high-risk individuals and to promote preventive interventions. This study will aim to evaluate the impact of a brief Dialectical Behavioral Therapy (DBT)-based intervention for adolescent students by measuring changes in emotional regulation skills and impulsive behaviors. Moreover, alterations in biological features related to stress response and inflammation will be assessed as potential biological variables associated with ED. METHODS This is a randomized trial. A total of 20 classes of adolescent students will be recruited among high schools in Brescia, a city in northern Italy. They will be randomized to the psychoeducational intervention (experimental group) or to a control condition (control group). The intervention will be based on DBT Skills Training for Emotional Problem Solving for Adolescents, and will consist of four monthly, 2-h sessions (for a total of 8 h) scheduled during regular school time. Participants will be assessed at baseline, post-intervention, and at 3 and 6 months of follow-up. The primary outcome measures will be represented by changes in the use of emotional regulation skills and by changes in the frequency of impulsive behaviors. Salivary samples will be collected at baseline and post-intervention to explore possible biological features underlying ED. DISCUSSION Data from the present project will offer the opportunity to better understand the complex phenomenon of ED. Repeated assessment will cover several domains (emotional, behavioral, social, biological) as potential factors associated with ED. Moreover, it will be possible to establish the effect of the proposed intervention, thus helping to improve knowledge on the impact of school-based universal preventive programs. Finally, the current trial will propose an integrated screening and intervention-based model. Ultimately, this could reduce barriers to youths' mental health care by fostering collaboration between schools and mental health services. TRIAL REGISTRATION ClinicalTrials.gov NCT04349709 . Registered on April 16, 2020.
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Affiliation(s)
- Laura Pedrini
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Roberta Rossi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Laura Rosa Magni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mariangela Lanfredi
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Ambra Macis
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
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15
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Arends RM, Grintjes KJT, van den Heuvel TJ, Foeken-Verwoert EGJ, Schene AH, van der Ven AJAM, Schellekens AFA. Effectiveness of a group intervention to reduce sexual transmission risk behavior among MSM living with HIV: a non-randomized controlled pilot study. AIDS Care 2021; 34:515-526. [PMID: 34851810 DOI: 10.1080/09540121.2021.2002252] [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: 10/19/2022]
Abstract
ABSTRACTWith an annual incidence of about 1.5 million new infections, HIV is an ongoing public health concern. Sexual transmission risk behavior (STRB) is a main driver of the HIV epidemic in most Western countries, particularly among specific populations such as men who have sex with men (MSM). This quasi-experimental pilot study examined the effectiveness of a ten-session group intervention, aiming to reduce STRB among a high-risk subpopulation of MSM living with HIV. Self-reported STRB, impulsivity, mental health symptoms, and functional impairment were compared between the intervention group (n = 12) and a control group (n = 16). At baseline, participants in the intervention group had higher levels of STRB, impulsivity, mental health problems, and functional impairment, compared to the control group. A significant time-by-group interaction effect revealed that after the intervention, STRB, impulsivity, and functional impairment reduced in the intervention group to levels comparable to the control group. These findings suggest that a targeted behavioral intervention might be an effective strategy to reduce persistent STRB and related factors in MSM living with HIV. Future studies should confirm these findings in larger samples, using randomized designs.
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Affiliation(s)
- Rachel M Arends
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | - Karin J T Grintjes
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Thom J van den Heuvel
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,GGNet, Scelta, Nijmegen, Netherlands
| | | | - Aart H Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Arnt F A Schellekens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Donders Center for Medical Neuroscience, Radboud University Medical Center, Nijmegen, Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, Netherlands
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16
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Zapolski T, Whitener M, Khazvand S, Crichlow Q, Revilla R, Salgado EF, Aalsma M, Cyders M, Salyers M, Wu W. Implementation of a Brief Dialectical Behavioral Therapy (DBT) Skills Group in High Schools for At-Risk Youth: Protocol for a Mixed-Methods Study (Preprint). JMIR Res Protoc 2021; 11:e32490. [PMID: 35551054 PMCID: PMC9136647 DOI: 10.2196/32490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Adolescence is a developmental period marked by engagement in risk-taking behaviors, especially among impulsive or emotionally dysregulated youth. Thus, interventions that teach skills to reduce the risk of negative outcomes associated with emotional dysregulation are required. Social and emotional learning (SEL) programs have been developed to address both adolescent emotional dysregulation and risk-taking behaviors; however, current programs have mostly been implemented among younger youth and are used as a tier 1 universal intervention rather than a targeted tier 2 intervention for youth identified with emotional regulation difficulties. Objective This study aimed to address the need for SEL programming that can be delivered in schools, particularly for older youth who have difficulties with emotional or behavioral dysregulation, to reduce the risk of health-risk behaviors among this population. Methods Here, we outline the implementation of an SEL intervention titled Going 4 Goals, a 9-session adaptation of the Dialectical Behavioral Therapy for Adolescents (DBT-A) program delivered to at-risk high school students in a school setting. The primary objectives of the study are to test whether participating in the skills group intervention produces significant increases in the core DBT-A skills of mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, while also producing significant decreases in substance use and risky behaviors. These primary outcomes are based on changes in participant scores between baseline and after the intervention and follow-ups at 1, 3, and 6 months compared with a control group of youth participating in the school’s health curriculum at the same time points. Qualitative interviews will also be conducted with intervention participants and school staff to examine acceptability and facilitators of and barriers to the intervention. Results A total of 171 participants across 13 groups had been enrolled in the intervention, with data collection ending December 2021. Data analysis will begin in the spring of 2022, with expected results to be published in the spring of 2023. Conclusions This paper describes the protocol of the 9-session school-based adaptation of the DBT-A intervention and discusses the strengths and limitations of the study and future directions. International Registered Report Identifier (IRRID) DERR1-10.2196/32490
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Affiliation(s)
- Tamika Zapolski
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - MacKenzie Whitener
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Shirin Khazvand
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | | | | | - Eduardo F Salgado
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Matthew Aalsma
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Melissa Cyders
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Michelle Salyers
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Wei Wu
- Department of Psychology, School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Examination of the SUPPS-P Impulsive Behavior Scale among Male and Female Youth: Psychometrics and Invariance. CHILDREN-BASEL 2021; 8:children8040283. [PMID: 33916949 PMCID: PMC8067604 DOI: 10.3390/children8040283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/02/2021] [Accepted: 04/04/2021] [Indexed: 11/21/2022]
Abstract
The UPPS-P Impulsive Behavior Scale is one of the most used and easily administered self-report measures of impulsive traits. The main objective of this study was to examine the psychometric properties of the shorter SUPPS-P scale among a school sample of 470 youth (Mage = 15.89 years, SD = 1.00) from Portugal, subdivided into males (n = 257, Mage = 15.97 years, SD = 0.98) and females (n = 213, Mage = 15.79 years, SD = 1.03). Confirmatory factor analysis results revealed that the latent five-factor structure (i.e., Negative urgency, Lack of perseverance, Lack of premeditation, Sensation seeking, and Positive urgency) obtained adequate fit and strong measurement invariance demonstrated across sex. The SUPPS-P scale also demonstrated satisfactory psychometric properties in terms of internal consistency, discriminant and convergent (e.g., with measures of youth delinquency, aggression) validities, and criterion-related validity (e.g., with crime seriousness). Findings support the use of the SUPPS-P scale in youth. Given the importance of adolescence as a critical period characterized by increases in impulsive behaviors, having a short, valid, reliable, and easily administered assessment of impulsive tendencies is important and clinically impactful.
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18
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Esposito C, Affuso G, Amodeo AL, Dragone M, Bacchini D. Bullying Victimization: Investigating the Unique Contribution of Homophobic Bias on Adolescent Non-suicidal Self-injury and the Buffering Role of School Support. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09434-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractResearch on bullying victimization has expanded to specific forms of harassment based on discriminatory bias, which involve aggressive behavior targeting an individual's identity characteristics, such as sexual orientation and/or gender expression. Recent studies have documented elevated health risks associated with victimization based on homophobic bias, above and beyond general victimization. The aim of the current study was to test the unique contribution of homophobic victimization on adolescent non-suicidal self-injury (NSSI) and to analyze the buffering role of teachers and classmates support. Participants were 770 adolescents (55.5% females; Mage = 15.35, SD = 1.62) enrolled in Italian public schools in grade nine (N = 483) and 12 (N = 287). All measures were collected during Spring 2016 using self-reported questionnaires. Zero-inflated Poisson regression analyses suggested that homophobic victimization had a unique contribution on NSSI frequency of engagement once initiated, but not on the probability of engaging in NSSI at least once. High classmates support was negatively associated with adolescents’ engagement in NSSI. Furthermore, higher levels of classmates support were associated with a lower NSSI frequency only for youth who reported low levels of homophobic victimization. In contrast, the association between classmates support and NSSI frequency was nonsignificant when youth reported high levels of homophobic victimization. No significant effects were found for teachers support. Overall, our findings underscore the need to address the serious concern of homophobic victimization within schools and the importance of promoting healthy and positive identity development in adolescence.
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19
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Ahrens KR, Udell W, Albertson K, Lowry S, Hoopes T, Coatney A. Development and two-phased pilot RCT of a foster/kinship caregiver intervention to improve sexual health communication with youth. CHILDREN AND YOUTH SERVICES REVIEW 2021; 122:105877. [PMID: 34992327 PMCID: PMC8725952 DOI: 10.1016/j.childyouth.2020.105877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Foster youth have high rates of unintended teen pregnancies and other negative sexual health outcomes. Foster and kinship caregivers (FKC) are an untapped resource to reduce risks. We conducted a two-phase pilot study to evaluate feasibility, acceptability and assess preliminary efficacy of a training designed to improve caregiver communication, monitoring and conflict behaviors and improve sexual health outcomes for youth in foster care. Our study included a Randomized Controlled Trial (RCT) component. METHOD Phase 1: We recruited 49 FKC and assessed feasibility quantitatively, and acceptability both qualitatively and quantitatively of our intervention (Heart to Heart). Phase 2: We conducted an RCT with 71 participants and evaluated caregiver communication, monitoring, and conflict behaviors as well as the psychological determinants thereof in intervention and control groups at 1, 3, and 6 months. RESULTS Phase 1: Facilitators delivered all intervention content; >90% participants received the entire training. The intervention was highly acceptable (mean score 4.9/5 on two questions). Phase 2: 71 participants were eligible and completed baseline (68 completed at least one follow up survey). We found significant improvements in the intervention group in knowledge, communication expectations, and caregiver-youth conflict behaviors in one or more waves; the control group demonstrated no significant improvements. When groups were compared, we found significant differences in knowledge, communication frequency, and conflict behaviors at 6 months. CONCLUSIONS Heart to Heart is feasible, acceptable, and preliminary outcomes data is promising. More research is needed to better establish evidence of efficacy for long-term behavior change in caregivers and youth. CLINICALTRIALSGOV IDENTIFER NCT03331016.
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Affiliation(s)
- Kym R Ahrens
- Center for Child Health, Behavior, and Development Research, Seattle Children’s Research Institute, Seattle, WA
- Adolescent Medicine Division, Department of Pediatrics, Seattle Children’s/University of Washington, Seattle, WA
| | - Wadiya Udell
- School of Interdisciplinary Arts and Sciences, University of Washington, Bothell WA
| | - Katie Albertson
- Center for Child Health, Behavior, and Development Research, Seattle Children’s Research Institute, Seattle, WA
| | - Sarah Lowry
- Center for Child Health, Behavior, and Development Research, Seattle Children’s Research Institute, Seattle, WA
| | - Teah Hoopes
- Public Health – Seattle and King County, Seattle, WA
| | - Alexis Coatney
- Center for Child Health, Behavior, and Development Research, Seattle Children’s Research Institute, Seattle, WA
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20
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Waddell JT, Sternberg A, Bui L, Ruof AR, Blake AJ, Grimm KJ, Elam KK, Eisenberg N, Chassin L. Relations Between Child Temperament and Adolescent Negative Urgency in a High-Risk Sample. JOURNAL OF RESEARCH IN PERSONALITY 2021; 90. [PMID: 33424044 DOI: 10.1016/j.jrp.2020.104056] [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] [Indexed: 10/22/2022]
Abstract
Negative urgency, rash action during negative mood states, is a strong predictor of risky behavior. However, its developmental antecedents remain largely unstudied. The current study tested whether childhood temperament served as a developmental antecedent to adolescent negative urgency. Participants (N=239) were from a longitudinal study oversampled for a family history of alcohol use disorder (AUD). Negative emotionality (anger and sadness reactivity) and effortful control were measured in childhood (5-8) and negative urgency in adolescence (13-18). Childhood anger reactivity was uniquely related to later negative urgency above and beyond sadness reactivity. Effortful control was not related to later negative urgency; however, a latent variable capturing the shared variance between childhood effortful control and anger reactivity was related to later negative urgency.
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21
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Ferguson E, Zale E, Ditre J, Wesolowicz D, Stennett B, Robinson M, Boissoneault J. CANUE: A Theoretical Model of Pain as an Antecedent for Substance Use. Ann Behav Med 2020; 55:489-502. [PMID: 32914834 DOI: 10.1093/abm/kaaa072] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Pain and substance use are frequently comorbid and have been shown to exert bidirectional effects. Self-medication of pain and distress via substance use is common and can be understood via negative reinforcement, ultimately strengthening the pathway between pain to substance use over time. As such, a testable model of the potentially modifiable candidate mechanisms that underlie the pain to substance use pathway is needed. PURPOSE This review proposes a testable model of pain as an antecedent to substance use to guide future research and inform clinical practice. METHODS An integrative review of current evidence regarding pain, substance use, and associated risk factors (i.e., negative affect, pain-related attitudes, negative urgency, and substance use outcome expectancies) was conducted. RESULTS The Catastrophizing, Anxiety, Negative Urgency, and Expectancy (CANUE) model highlights modifiable risk factors for self-medicating pain with substance use, including increased negative affect and maladaptive pain-related attitudes (i.e., pain catastrophizing, pain anxiety, and fear of pain), negative urgency, and substance-related outcome expectancies for pain relief and enhanced pain coping. CONCLUSIONS Targeted behavioral and psychological interventions that address these factors may facilitate more adaptive pain-coping responses, thereby reducing the impacts of pain on substance use. Systematic research is needed to evaluate the validity and clinical utility of this model.
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Affiliation(s)
- Erin Ferguson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL USA
| | - Emily Zale
- Department of Psychology, Binghamton University, State University of New York, Binghamton, NY, USA
| | - Joseph Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Danielle Wesolowicz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL USA
| | - Bethany Stennett
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL USA
| | - Michael Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL USA
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.,Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL USA
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22
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Johnson SL, Zisser MR, Sandel DB, Swerdlow BA, Carver CS, Sanchez AH, Fernandez E. Development of a brief online intervention to address aggression in the context of emotion-related impulsivity: Evidence from a wait-list controlled trial. Behav Res Ther 2020; 134:103708. [PMID: 32896743 DOI: 10.1016/j.brat.2020.103708] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/01/2020] [Accepted: 08/04/2020] [Indexed: 11/15/2022]
Abstract
Trait-like tendencies to respond impulsively to emotion, labelled emotion-related impulsivity, are robustly related to aggression. We developed and tested an online intervention to address emotion-related impulsivity and aggression. The 6-session intervention focused on behavioral techniques shown to decrease arousal and aggression, supplemented with implementation intentions and smartphone prompts to facilitate skills transfer into daily life. First, we piloted the intervention in-person with 4 people. Then, 235 participants were randomly assigned to take the online intervention immediately or after a wait-list period; those in the waitlist were then invited to take part in the intervention. Participants completed the self-rated Feelings Trigger Action Scale to assess emotion-related impulsivity, the interview-based Modified Overt Aggression Scale and the self-rated Buss Perry Aggression Questionnaire. Participants who took part in the treatment completed daily anger logs. Attrition, as with other online programs, was high; however, treatment completers reported high satisfaction, and outcomes changed more rapidly during treatment than waitlist across all key outcome indices. In analyses including all participants who took part in the treatment (immediate or delayed), we observed moderate-to-large treatment gains, which were maintained as of the 3-month follow-up assessment. This work supports the usefulness of an intervention for addressing emotion-related impulsivity and aggression.
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23
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Baetens I, Decruy C, Vatandoost S, Vanderhaegen B, Kiekens G. School-Based Prevention Targeting Non-Suicidal Self-injury: A Pilot Study. Front Psychiatry 2020; 11:437. [PMID: 32587530 PMCID: PMC7298560 DOI: 10.3389/fpsyt.2020.00437] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 04/28/2020] [Indexed: 12/15/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI.
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Affiliation(s)
- Imke Baetens
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Christine Decruy
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Shokoufeh Vatandoost
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Birgit Vanderhaegen
- Department of Neuroscience, School of Medicine, Institute for Family and Sexuality Studies KU Leuven, Leuven, Belgium
| | - Glenn Kiekens
- Department of Neurosciences, Center for Public Health Psychiatry KU Leuven, Leuven, Belgium
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Katz J, Knight V, Mercer SH, Skinner SY. Effects of a Universal School-Based Mental Health Program on the Self-concept, Coping Skills, and Perceptions of Social Support of Students with Developmental Disabilities. J Autism Dev Disord 2020; 50:4069-4084. [DOI: 10.1007/s10803-020-04472-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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25
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Johnson SL, Sandel DB, Zisser M, Pearlstein JG, Swerdlow BA, Sanchez AH, Fernandez E, Carver CS. A brief online intervention to address aggression in the context of emotion-related impulsivity for those treated for bipolar disorder: Feasibility, acceptability and pilot outcome data. JOURNAL OF BEHAVIORAL AND COGNITIVE THERAPY 2020; 30:65-74. [PMID: 34113851 DOI: 10.1016/j.jbct.2020.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Although aggression is related to manic symptoms among those with bipolar disorder, new work suggests that some continue to experience elevations of aggression after remission. This aggression post-remission appears related to a more general tendency to respond impulsively to states of emotion, labelled emotion-related impulsivity. We recently developed the first intervention designed to address aggression in the context of emotion-related impulsivity. Here, we describe feasibility, acceptability, and pilot data on outcomes for 21 persons who received treatment for bipolar disorder and endorsed high levels of aggression and emotion-related impulsivity. As with other interventions for aggression or bipolar disorder, attrition levels were high. Those who completed the intervention showed large changes in aggression using the interview-based Modified Overt Aggression Scale that were sustained through three months and not observed during wait list control. Although they also showed declines in the self-rated Buss-Perry Aggression Questionnaire and in self-rated emotion-related impulsivity as assessed with the Feelings Trigger Action Scale, these self-ratings also declined during the waitlist control. t Despite the limitations, the findings provide the first evidence that a brief, easily disseminated intervention could have promise for reducing aggression among those with bipolar disorder.
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Affiliation(s)
- Sheri L Johnson
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Devon B Sandel
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Mackenzie Zisser
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Jennifer G Pearlstein
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Benjamin A Swerdlow
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Amy H Sanchez
- University of California Berkeley, Mail Code 2010, Berkeley Way West Room 3302, 2121 Berkeley Way, 94720-2010 Berkeley, CA, United States
| | - Ephrem Fernandez
- University of Texas San Antonio, San Antonio, Texas, United States
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26
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Reilly EE, Orloff NC, Luo T, Berner LA, Brown TA, Claudat K, Kaye WH, Anderson LK. Dialectical behavioral therapy for the treatment of adolescent eating disorders: a review of existing work and proposed future directions. Eat Disord 2020; 28:122-141. [PMID: 32301680 DOI: 10.1080/10640266.2020.1743098] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Over the past several decades, Dialectical Behavior Therapy (DBT) has been adapted for a range of presenting problems related to emotion dysregulation. Considerable enthusiasm exists regarding the use of DBT for treating eating disorders; however, to date, there have been no reviews summarizing empirical efforts to adapt DBT for eating disorders in youth. Accordingly, in the present narrative review, we provide a comprehensive summary of existing work testing DBT for adolescent eating disorders. First, we briefly review existing work applying DBT to eating disorders in adults and general adolescent samples. We then review research focused specifically on the use of DBT for adolescent eating disorders, including both those studies applying DBT as the primary treatment and investigations of DBT as an adjunctive treatment. Overall, initial results for DBT-based approaches are promising. However, rigorous empirical work testing DBT for treating adolescent eating disorders remains limited; the majority of existing research is comprised of case series and small-scale studies. Therefore, we close with specific recommendations for future research testing this approach.
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Affiliation(s)
- Erin E Reilly
- Department of Psychiatry, University of California, San Diego, CA, USA.,Department of Psychology, Hofstra University, Hempstead, NY, USA
| | - Natalia C Orloff
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Tana Luo
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Laura A Berner
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Tiffany A Brown
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Kimberly Claudat
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Walter H Kaye
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Leslie K Anderson
- Department of Psychiatry, University of California, San Diego, CA, USA
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Kamody RC, Thurston IB, Burton ET. Acceptance-based skill acquisition and cognitive reappraisal in a culturally responsive treatment for binge eating in adolescence. Eat Disord 2020; 28:184-201. [PMID: 32151205 DOI: 10.1080/10640266.2020.1731055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Emotional overeating, or eating in excess to soothe negative emotions, is a high-risk behavior for the future development of the binge-eating disorder (BED). The Emotional Overeating Intervention (EOI) is a culturally responsive, 10-week condensed dialectical behavior therapy (DBT) skills group intervention for adolescents endorsing emotional-overeating and binge-eating behaviors. The present study served as a secondary analysis of the intervention data, with the aim of using quantitative measures and qualitative interviews to examine intervention acceptability and DBT skill acquisition. Data were analyzed using descriptive statistics for quantitative surveys and qualitative content analysis for interviews. Among the 15 adolescents (Mage = 15.40 years; 73.3% identifying as female; 100% identifying as Black) who participated in the EOI pilot trial, most identified learning acceptance-based DBT skills, particularly radical acceptance, as both highly acceptable and the most useful aspect of treatment. Participants reported increases in distress tolerance appraisal and emotion regulation cognitive reappraisal scale scores from baseline to post-intervention. Accordingly, acceptance-based DBT skills may be associated with change-based cognitive strategies, which may contribute to improvements in emerging BED pathology. Findings serve as an initial step in informing preventative models of scalable interventions for subthreshold BED among adolescents, by identifying variables that warrant investigation as potential mechanisms of change.
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Affiliation(s)
- Rebecca C Kamody
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Idia B Thurston
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA.,Department of Psychological and Brain Sciences, Department of Health Promotion and Community Health Sciences, Texas A & M University, College Station, Texas, USA.,Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - E Thomaseo Burton
- Department of Pediatrics, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee, USA
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28
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Johnson SL, Elliott MV, Carver CS. Impulsive Responses to Positive and Negative Emotions: Parallel Neurocognitive Correlates and Their Implications. Biol Psychiatry 2020; 87:338-349. [PMID: 31668478 PMCID: PMC7012660 DOI: 10.1016/j.biopsych.2019.08.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/21/2019] [Accepted: 08/22/2019] [Indexed: 11/19/2022]
Abstract
Theory about the conceptual basis of psychiatric disorders has long emphasized negative emotionality. More recent ideas emphasize roles for positive emotionality and impulsivity as well. This review examines impulsive responses to positive and negative emotions, which have been labeled as urgency. Urgency is conceptually and empirically distinct from other forms of impulsivity. A large body of work indicates that urgency is more robustly related to psychopathology than are other forms of impulsivity. Researchers have considered 4 neurocognitive models of urgency: excessive emotion generation, poor emotion regulation, risky decision making, and poor cognitive control. Little evidence supports emotion generation or risky decision making as the core issues driving urgency. Rather, urgency appears related to dysfunction in key hubs implicated in the integration of cognitive control and emotion regulation (e.g., the orbitofrontal cortex and anterior insula), expressed as response inhibition deficits that emerge most robustly in high arousal contexts. These neurocognitive processes appear remarkably parallel for positive and negative urgency. We provide methodological suggestions and theoretical hypotheses to guide future research.
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Affiliation(s)
- Sheri L Johnson
- Department of Psychology, University of California, Berkeley, Berkeley, California.
| | - Matthew V Elliott
- Department of Psychology, University of California, Berkeley, Berkeley, California
| | - Charles S Carver
- Department of Psychology, University of Miami, Coral Gables, Florida
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Liu M, Argyriou E, Cyders MA. Developmental Considerations for Assessment and Treatment of Impulsivity in Older Adults. Curr Top Behav Neurosci 2020; 47:165-177. [PMID: 31907880 DOI: 10.1007/7854_2019_124] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Impulsivity is an important factor in many clinical disorders, especially alcohol and substance use disorders. Most of the research on impulsivity in this domain has focused on adolescence and young adulthood, as this developmental period is characterized by onset of and escalation in alcohol and substance use, likely driven in part by brain development patterns. Although many individuals eventually "mature out" of these behaviors in middle adulthood, a critical subset of people do not. The role of impulsivity in middle-to-older adulthood, when certain individuals transition from normative to disordered substance use, has not been carefully examined. The goal of this paper is to review the literature on measuring and modifying impulsivity from adolescence through older adulthood, with a special focus on middle-to-older adulthood. We propose that impulsivity research should include data on middle-to-older adulthood as an important time of transition to disordered use. We consider how impulsivity might have unique meaning at different stages of the adult lifespan and suggest modifications for assessing and treating impulsivity in older adults.
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Affiliation(s)
- Melissa Liu
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Eva Argyriou
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Melissa A Cyders
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA.
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30
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Atkinson EA, Ortiz AML, Smith GT. Affective Risk for Problem Drinking: Reciprocal Influences Among Negative Urgency, Affective Lability, and Rumination. Curr Drug Res Rev 2020; 12:42-51. [PMID: 31736451 DOI: 10.2174/2589977511666191021105154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/13/2019] [Accepted: 09/13/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Affective disturbances have long been implicated in the onset and maintenance of problematic alcohol use. Affective risk theory for problem drinking has moved beyond early documentation that negative affect broadly confers risk to models specifying specific affectbased risk processes. OBJECTIVE This paper provides a theory-driven review of recent literature on the role of affect-based factors in the etiology of problematic alcohol use. First, we review recent advances in the understanding of affect-based risk for problem drinking. Second, we highlight the importance of three specific affect-based risk factors: urgency, affective lability, and rumination. Third, we offer hypotheses regarding the reciprocal relationships between specific risk factors and drinking problems. Finally, we suggest possible avenues for future research. CONCLUSION Recent advances in the understanding of reciprocal prediction between affect-based risk factors and problem drinking have set the stage for important new avenues of investigation into the risk process. Affect-based risk processes appear to influence each otherover time, and they influence and are influenced by problem drinking. Further understanding of these processes will pave the way for a new generation of intervention strategies.
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Affiliation(s)
- Emily A Atkinson
- Department of Psychology, University of Kentucky, Lexington KY, 40506, Kentucky, United States
| | - Anna M L Ortiz
- Department of Psychology, University of Kentucky, Lexington KY, 40506, Kentucky, United States
| | - Gregory T Smith
- Department of Psychology, University of Kentucky, Lexington KY, 40506, Kentucky, United States
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31
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Developing Self-concept, Coping Skills, and Social Support in Grades 3–12: A Cluster-Randomized Trial of a Combined Mental Health Literacy and Dialectical Behavior Therapy Skills Program. SCHOOL MENTAL HEALTH 2019. [DOI: 10.1007/s12310-019-09353-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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32
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Hellberg SN, Ladis IE, Shepherd CB. Pilot study of a personality-based approach to assessing eating disorder and Obsessive Compulsive Disorder symptom risk in college men and women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:801-816. [PMID: 30570434 DOI: 10.1080/07448481.2018.1515745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/10/2018] [Accepted: 08/18/2018] [Indexed: 06/09/2023]
Abstract
Objective: To conduct a pilot test of the validity of using empirically derived personality types to characterize eating disorder (ED) risk in college students and resolve discrepancies regarding the role of perfectionism and obsessive-compulsive disorder (OCD) symptoms.Participants: Man and woman undergraduate students (N = 169) at a small, private university. Data were collected from February to May 2016 and 2018. Methods: Participants completed self-report measures of personality (perfectionism, impulsivity, and effortful control) and psychopathology (EDs, OCD). Results: Our analyses replicated three validated personality types: overcontrolled, undercontrolled, and resilient. Analysis of variances demonstrated perfectionism, ED, and OCD symptoms were significantly elevated in the overcontrolled subtype. There was no interaction by sex. Conclusions: These findings suggest that personality types may be useful for classifying ED risk and OCD symptoms in college students across sexes. Further study and relevance to prevention and intervention efforts to reduce the burden of EDs on college campuses will be discussed.
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Affiliation(s)
- Samantha N Hellberg
- Wesleyan University, Middletown, CT, USA
- Massachusetts General Hospital, Boston, MA, USA
| | - Ilana E Ladis
- Wesleyan University, Middletown, CT, USA
- Massachusetts General Hospital, Boston, MA, USA
| | - Caitlin B Shepherd
- Wesleyan University, Middletown, CT, USA
- Smith College, Northampton, MA, USA
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33
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Whitt ZT, Bernstein M, Spillane N, Stein LAR, Suffoletto B, Neighbors C, Schick MR, Cyders MA. Positive urgency worsens the impact of normative feedback on 21st birthday drinking. Drug Alcohol Depend 2019; 204:107559. [PMID: 31563804 PMCID: PMC6878139 DOI: 10.1016/j.drugalcdep.2019.107559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/01/2018] [Accepted: 11/15/2018] [Indexed: 10/26/2022]
Abstract
BACKGROUND The 21st birthday is associated with more alcohol consumption and negative consequences than any other occasion. The current study investigated how positive urgency, the tendency to act rashly in response to positive emotions, influences 21st birthday drinking and the effectiveness of a single event text message intervention designed to reduce 21st birthday drinking and related negative consequences. METHODS Participants were 183 undergraduate students (69% female, 86% white) about to turn 21. Participants were randomly assigned to either a text message intervention or control condition. Those in the intervention condition received one text message the day before their 21st birthday that provided personalized normative feedback and one text message on the day of their 21st birthday. Participants reported actual alcohol consumption the day after their 21st birthday celebration. RESULTS Hierarchical linear regression found that, after controlling for sex, intervention condition, and planned drinking, positive urgency was associated with greater number of drinks (β = .15, p = .031) and drinking problems (β = .25, p = .001). A moderated-mediation model was significant (B = 0.42, CI95 [.10, .76]): At high levels of positive urgency, the intervention condition was associated with drinking more than planned, which significantly mediated the relationship between intervention and alcohol-related consequences; the mediation was not significant at mean or low levels of positive urgency. CONCLUSIONS These findings are the first to link positive urgency with 21st birthday drinking and to empirically demonstrate that positive urgency negatively impacts the effectiveness of an intervention aimed at reducing alcohol consumption.
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Affiliation(s)
- Zachary T Whitt
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States.
| | - Michael Bernstein
- Brown University, Center for Alcohol and Addiction Studies, Providence, RI, United States
| | - Nichea Spillane
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | - L A R Stein
- Brown University, Center for Alcohol and Addiction Studies, Providence, RI, United States; Department of Psychology, University of Rhode Island, Kingston, RI, United States; Rhode Island Training School, Department of Children, Youth and Families, Cranston, RI, United States
| | - Brian Suffoletto
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Clayton Neighbors
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Melissa R Schick
- Department of Psychology, University of Rhode Island, Kingston, RI, United States
| | - Melissa A Cyders
- Department of Psychology, Indiana University - Purdue University Indianapolis, Indianapolis, IN, United States
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34
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Guo Y, Rousseau J, Hsu AS, Kehoe P, Daviss M, Flores S, Renno P, Saunders K, Phillips S, Evangelista LS. Emotional and Behavioral Health Needs in Elementary School Students in an Underserved Hispanic Community. J Sch Nurs 2019; 35:128-136. [PMID: 28893118 DOI: 10.1177/1059840517726857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
High rates of mental health problems in adolescents have been well documented; less is known about elementary school children in disadvantaged communities. We examined emotional and behavioral health needs in 202 third and fourth graders enrolled in a charter school in a largely Hispanic community. The child-reported Revised Child Anxiety and Depression Scale-25 and Teacher's Report Form were used to evaluate mental health needs as perceived by these children and their teachers. The prevalence of teacher-reported depression and child self-reported anxiety was 7.0% and 6.67%, respectively. Living in a single parent household was found to be a specific risk factor in that those children had higher rates of emotional and behavioral problems than children living with both parents. Evidence of higher depression and anxiety identified in this sample compared to national representative data suggests the need for development of culturally sensitive early prevention and intervention in this underserved community.
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Affiliation(s)
- Yuqing Guo
- 1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - Julie Rousseau
- 1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - Anna S Hsu
- 2 Department of Psychology and Social Behavior, University of California, Irvine, CA, USA
| | - Priscilla Kehoe
- 1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - Monique Daviss
- 3 El Sol Science and Arts Academy of Santa Ana, Santa Ana, CA, USA
| | - Sara Flores
- 3 El Sol Science and Arts Academy of Santa Ana, Santa Ana, CA, USA
| | - Patricia Renno
- 4 Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Kathleen Saunders
- 1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
| | - Susanne Phillips
- 1 Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
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35
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Halcomb M, Argyriou E, Cyders MA. Integrating Preclinical and Clinical Models of Negative Urgency. Front Psychiatry 2019; 10:324. [PMID: 31191369 PMCID: PMC6541698 DOI: 10.3389/fpsyt.2019.00324] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/26/2019] [Indexed: 12/31/2022] Open
Abstract
Overwhelming evidence suggests that negative urgency is robustly associated with rash, ill-advised behavior, and this trait may hamper attempts to treat patients with substance use disorder. Research applying negative urgency to clinical treatment settings has been limited, in part, due to the absence of an objective, behavioral, and translational model of negative urgency. We suggest that development of such a model will allow for determination of prime neurological and physiological treatment targets, the testing of treatment effectiveness in the preclinical and the clinical laboratory, and, ultimately, improvement in negative-urgency-related treatment response and effectiveness. In the current paper, we review the literature on measurement of negative urgency and discuss limitations of current attempts to assess this trait in human models. Then, we review the limited research on animal models of negative urgency and make suggestions for some promising models that could lead to a translational measurement model. Finally, we discuss the importance of applying objective, behavioral, and translational models of negative urgency, especially those that are easily administered in both animals and humans, to treatment development and testing and make suggestions on necessary future work in this field. Given that negative urgency is a transdiagnostic risk factor that impedes treatment success, the impact of this work could be large in reducing client suffering and societal costs.
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Affiliation(s)
- Meredith Halcomb
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine Indianapolis, Indianapolis, IN, United States
| | - Evangelia Argyriou
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
| | - Melissa A Cyders
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, United States
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36
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Peters JR, Eisenlohr-Moul TA, Walsh EC, Derefinko KJ. Exploring the pathophysiology of emotion-based impulsivity: The roles of the sympathetic nervous system and hostile reactivity. Psychiatry Res 2018; 267:368-375. [PMID: 29957555 PMCID: PMC6309543 DOI: 10.1016/j.psychres.2018.06.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 11/22/2022]
Abstract
The tendency to engage in impulsive behavior in the context of negative affect, known as negative urgency, has emerged as a powerful transdiagnostic predictor of behavioral dysregulation. Although general vulnerability to negative affect (neuroticism) correlates with negative urgency, not all neurotic individuals engage in urgent behavior. Given prior experimental evidence that sympathetic nervous system (SNS) activation may promote emotion-related impulsivity, the present study examines tonic SNS activity as a moderator of the link between neuroticism and negative urgency. Participants (N = 194) completed measures of neuroticism and negative urgency, as well as a stress task. They also underwent assessment of tonic SNS activity (cardiac pre-ejection period). The link between neuroticism and negative urgency was strengthened for individuals with higher tonic SNS activity; however, this was not the case for behavioral performance on the task. A similar pattern was demonstrated for hostile reactivity to the stress task; increased hostile response partially explained the interaction between SNS activation and neuroticism on negative urgency. These findings suggest a potential facilitative role of the SNS in hostile reactivity and emotion-driven impulsivity among more neurotic individuals.
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Affiliation(s)
- Jessica R Peters
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
| | | | - Erin C Walsh
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen J Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
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Davis HA, Smith GT. An integrative model of risk for high school disordered eating. JOURNAL OF ABNORMAL PSYCHOLOGY 2018; 127:559-570. [PMID: 29927266 DOI: 10.1037/abn0000365] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Binge eating and purging behaviors are associated with significant harm and distress among adolescents. The process by which these behaviors develop (often in the high school years) is not fully understood. We tested the Acquired Preparedness (AP) model of risk involving transactions among biological, personality, and psychosocial factors to predict binge eating and purging behavior in a sample of 1,906 children assessed in the spring of 5th grade (the last year of elementary school), the fall of 6th grade (the first year of middle school), spring of 6th grade, and spring of 10th grade (second year of high school). Pubertal onset in spring of 5th grade predicted increases in negative urgency, but not negative affect, in the fall of 6th grade. Negative urgency in the fall of 6th grade predicted increases in expectancies for reinforcement from eating in the spring of 6th grade, which in turn predicted increases in binge eating behavior in the spring of 10th grade. Negative affect in the fall of 6th grade predicted increases in thinness expectancies in the spring of 6th grade, which in turn predicted increases in purging in the spring of 10th grade. Results demonstrate similarities and differences in the development of these two different bulimic behaviors. Intervention efforts targeting the risk factors evident in this model may prove fruitful in the treatment of eating disorders characterized by binge eating and purging. (PsycINFO Database Record
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38
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Reinbergs EJ, Fefer SA. Addressing trauma in schools: Multitiered service delivery options for practitioners. PSYCHOLOGY IN THE SCHOOLS 2018. [DOI: 10.1002/pits.22105] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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39
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Um M, Hershberger AR, Whitt ZT, Cyders MA. Recommendations for applying a multi-dimensional model of impulsive personality to diagnosis and treatment. Borderline Personal Disord Emot Dysregul 2018; 5:6. [PMID: 29619225 PMCID: PMC5879935 DOI: 10.1186/s40479-018-0084-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/13/2018] [Indexed: 01/10/2023] Open
Abstract
The UPPS-P Model of Impulsive Personality, a prominent model of impulsive personality derived from the Five Factor Model of Personality, is a multi-dimensional model of impulsive personality that consists of negative urgency, lack of premeditation, lack of perseveration, sensation seeking, and positive urgency. The UPPS-P model has highlighted the importance of separating multidimensional traits due to the specificity of these traits corresponding to different risk behaviors. The goal of the current review paper is to make recommendations on how to apply the UPPS-P Model of Impulsive Personality, to diagnosis of and treatment for psychopathology. However, despite impulsivity being one of the most frequently used criteria for a number of clinical disorders, our review of the Diagnostic and Statistical Manual for Mental Disorders-5 found that the UPPS-P traits are not well represented in the diagnostic criteria, which we propose limits inferences about etiology and treatment targets. Additionally, research has largely focused on the importance of these traits for risk models; our review of the literature applying the UPPS-P traits to treatment processes and outcomes concluded that this area is not yet well studied. Here, we propose the specific application of the UPPS-P model to improve diagnosis and increase treatment effectiveness.
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Affiliation(s)
- Miji Um
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Alexandra R Hershberger
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Zachary T Whitt
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
| | - Melissa A Cyders
- Department of Psychology, Indiana University - Purdue University Indianapolis, 402 N Blackford St, LD 124, Indianapolis, IN 46202 USA
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40
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Burris JL, Riley E, Puleo GE, Smith GT. A longitudinal study of the reciprocal relationship between ever smoking and urgency in early adolescence. Drug Alcohol Depend 2017; 178:519-526. [PMID: 28719886 PMCID: PMC5555077 DOI: 10.1016/j.drugalcdep.2017.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/18/2017] [Accepted: 06/03/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Among early adolescents in the United States (U.S.), the prevalence of cigarette smoking is at its lowest level in recent decades. Nonetheless, given the risks of smoking in early development, it remains critically important to study both risk factors for smoking and risks from smoking. This longitudinal study with U.S. early adolescents examines smoking initiation and tests a model of reciprocal prediction between ever smoking and the personality trait of urgency (i.e., mood-based impulsivity), a trait that increases risk for multiple forms of dysfunction. METHODS Participants (n=1906; 90% 10-11 years old, 50% female, 39% racial minorities at baseline) completed questionnaires 1-2 times per year starting in 5th grade and ending in 9th grade. Structural equation modeling allowed tests of bidirectional relationships between ever smoking and urgency controlling for pubertal status and negative affect at each wave. RESULTS Incidence of ever smoking increased from 5% to 27% over time, with current smoking around 5% at the last wave. Urgency at each wave predicted ever smoking at the next wave above and beyond covariates and prior smoking (all p<0.01). Likewise, with one exception, ever smoking predicted an increase in urgency at the subsequent wave above and beyond covariates and prior urgency (all p<0.05). CONCLUSION Results show that risk for smoking increases with higher levels of urgency and urgency increases secondary to engagement in smoking. Future work should therefore explore urgency as a point of prevention for smoking and smoking cessation as a means to mitigate mood-based impulsivity.
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Affiliation(s)
- Jessica L. Burris
- Department of Psychology and Markey Cancer Center, University of Kentucky, Lexington, KY, USA, University of Kentucky, 206 Combs Cancer Research Building, Lexington, KY 40536-0096, USA;
| | - Elizabeth Riley
- Department of Psychology, University of Kentucky, 171 Funkhouser Dr., Lexington, KY 40506-0044, USA.
| | - Gabriella E. Puleo
- Department of Psychology, University of Kentucky, Lexington, KY, USA, University of Kentucky, 171 Funkhouser Dr., Lexington, KY 40506-0044, USA;
| | - Gregory T. Smith
- Department of Psychology, University of Kentucky, Lexington, KY, USA, University of Kentucky, 105 Kastle Hall, Lexington, KY 40506-0044, USA;
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McDonald CC, Brawner BM, Fargo J, Swope J, Sommers MS. Development of a Theoretically Grounded, Web-Based Intervention to Reduce Adolescent Driver Inattention. J Sch Nurs 2017; 34:270-280. [PMID: 28553750 DOI: 10.1177/1059840517711157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk and often results from distractions, such as cell phone calls, texting, and peer passengers. We report on the development of a web-based intervention based on the Theory of Planned Behavior that aims to reduce adolescent driver inattention ( Let's Choose Ourselves). In Phase I, we collected qualitative and quantitative data on adolescents' attitudes, perceived behavioral control, and subjective norms about driver inattention through focus groups with newly licensed adolescent drivers. In Phase II, we developed the content in an e-learning delivery system, performed beta- and pilot testing, and made refinements. In Phase III, we conducted a randomized controlled trial to evaluate feasibility. The development of Let's Choose Ourselves provides information for school nurses regarding intervention development strategies as well as promotion of safe adolescent driving by reducing driver inattention.
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Affiliation(s)
- Catherine C McDonald
- 1 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.,2 Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,3 Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jamison Fargo
- 4 Department of Psychology, Utah State University, Logan, UT, USA
| | - Jennifer Swope
- 5 The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Marilyn S Sommers
- 1 School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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