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Mansueto G, Palmieri S, Sassaroli S, Ruggiero GM, Caselli G, Calligaro D, Manigrasso A, Nikčevic A, Spada MM. Emotion dysregulation in participants with substance use disorders: A metacognitive perspective. J Affect Disord 2024; 363:63-71. [PMID: 39038617 DOI: 10.1016/j.jad.2024.07.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/24/2024] [Accepted: 07/17/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND Using the metacognitive model of emotion dysregulation as a basis, this study explored whether, among participants with substance use disorders (SUDs), metacognitive beliefs and repetitive negative thinking were associated with emotion dysregulation. METHODS 127 participants with SUDs and 127 controls without SUDs were recruited. Emotion dysregulation, metacognitive beliefs, rumination, worry, anxiety, and depression were assessed. t-tests, Mann-Whitney tests, logistic regression, correlation, and hierarchal regression analyses were run. RESULTS Participants with SUDs reported significantly higher levels of emotion dysregulation, positive beliefs about worry, beliefs about the need to control thoughts, rumination, and worry, compared to controls without SUDs. Among participants with SUDs negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, beliefs about the need to control thoughts, rumination, and worry were significantly associated with an increase of emotion dysregulation. LIMITATIONS The cross-sectional design. CONCLUSION Emotion dysregulation, metacognitive beliefs, and repetitive negative thinking may contribute to increase the risk of substance use. Among participants with SUDs emotion dysregulation is associated with the tendency to endorse dysfunctional metacognitive beliefs and report repetitive negative thinking. Metacognitive beliefs and repetitive negative thinking could be a suitable therapeutic target to reduce emotion dysregulation among participants with SUDs.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy; School of Applied Sciences, London South Bank University, London, UK.
| | - Sara Palmieri
- School of Applied Sciences, London South Bank University, London, UK; Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Sandra Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Gabriele Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy; Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Dalila Calligaro
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Antonella Manigrasso
- Cognitive Psychotherapy School and Research Center, Studi Cognitivi, Milan, Italy
| | - Ana Nikčevic
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, Kingston upon Thames, UK
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Ferguson E, Busch AM, Anderson B, Abrantes AM, Pinkston MM, Baker JV, Stein MD, Uebelacker LA. Avoidance and Rumination as Predictors of Substance Use, Mental Health, and Pain Outcomes Among People Living With HIV. Behav Ther 2024; 55:1015-1025. [PMID: 39174262 PMCID: PMC11341950 DOI: 10.1016/j.beth.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 02/22/2024] [Accepted: 02/29/2024] [Indexed: 08/24/2024]
Abstract
Pain, substance use, and mental health conditions are common among people living with HIV (PLWH), and avoidance and rumination may influence the co-occurrence of these conditions. The present study examined longitudinal associations between avoidance/rumination and pain outcomes, anxiety, anger, and substance use among PLWH. Participants (N = 187) with chronic pain and depressive symptoms completed self-report assessments over a 1-year period. Greater avoidance/rumination was positively associated with mental health outcomes (anxiety, anger), pain interference, and alcohol use across participants after controlling for depression severity. At time points with greater avoidance/rumination than average, participants also reported increased pain severity and interference, anxiety and anger symptoms, and alcohol use. No associations were found between avoidance/rumination and cannabis use. Results suggest a mechanistic effect of avoidance/rumination, such that increases in avoidance/rumination correspond with poorer health outcomes among PLWH over time. Targeting avoidance/rumination through intervention approaches may be beneficial for addressing comorbid health conditions among PLWH. Additional research is necessary to investigate this possibility and further characterize the effects of avoidance/rumination on health outcomes for PLWH.
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Affiliation(s)
| | - Andrew M Busch
- Hennepin Healthcare and University of Minnesota Medical School
| | | | - Ana M Abrantes
- Alpert Medical School of Brown University and Butler Hospital
| | - Megan M Pinkston
- Alpert Medical School of Brown University and Lifespan Physicians Group, the Miriam Hospital
| | - Jason V Baker
- Hennepin Healthcare and University of Minnesota Medical School
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Li D, Wang D, Ren H, Tian Y, Chen J, Zhu R, Li Y, Wang L, Zhang XY. Association between rumination and drug craving in Chinese male methamphetamine use disorder patients with childhood trauma. CHILD ABUSE & NEGLECT 2023; 144:106357. [PMID: 37459735 DOI: 10.1016/j.chiabu.2023.106357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/18/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
BACKGROUND In China, males make up the majority of methamphetamine (MA) dependent individuals and the majority of treatment seekers. Childhood trauma (CT) and rumination are associated with an increased risk of MA use. However, the association between CT, rumination, and drug craving remains largely unknown. OBJECTIVE The present study aims to explore the association between rumination and drug craving in methamphetamine use disorder (MAUD) patients with CT. PARTICIPANTS AND SETTING This study recruited 404 male participants with MAUD from a male drug rehabilitation center in Southwest China. METHODS Patients with CT were identified by the short form of Childhood Trauma Questionnaire (CTQ-SF). Rumination and drug craving were assessed by the Ruminative Responses Scale (RRS) and the Obsessive Compulsive Drug Use Scale (OCDUS), respectively. RESULTS 188 patients (46.5 %) experienced CT. Patients who had experienced CT showed significantly higher RRS symptom rumination score and OCDUS total score than those who had not. In patients with CT, RRS total and all subscale scores were positively associated with OCDUS interference of drug. Furthermore, the RRS brooding (β = 0.34, p < 0.001) and total scores (β = 0.38, p < 0.001) were determined to be separate contributors to the OCDUS total score in patients with CT. CONCLUSIONS Our study suggests that CT is common in male MAUD patients, and those who have suffered CT may exhibit higher levels of rumination and drug craving. Moreover, CT may play an influential role in the association between rumination and drug craving in patients with MAUD.
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Affiliation(s)
- Deyang Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Hengqin Ren
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Hamonniere T, Billieux J. Individually delivered mindfulness-based cognitive therapy in concomitant problematic substance use and emotional symptoms: A process-based case study. Clin Psychol Psychother 2023. [PMID: 36639943 DOI: 10.1002/cpp.2827] [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: 06/20/2022] [Revised: 12/21/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
The process-based approach assumes that transdiagnostic psychological processes are involved in the onset and maintenance of mental disorders. Case conceptualization is used to identify such psychological processes and to individualize the intervention accordingly. This approach is fundamentally different from syndrome-based approaches in which standardized treatments are administered for psychiatric diagnoses or symptoms. In the current case, we proposed a process-based conceptualization and treatment for a woman with concomitant problematic substance use and emotional symptoms. Our idiosyncratic process-based conceptualization showed that for this person, substance abuse consisted in a maladaptive coping strategy to deal with repetitive negative thinking and poor emotion regulation skills, for which we decided to use a mindfulness-based intervention. Treatment comprised 8 weeks of individually delivered mindfulness-based cognitive therapy sessions. A comprehensive assessment of psychiatric symptoms and psychological processes was conducted at baseline, post-intervention and 3-month follow-up. The post-treatment assessment revealed that psychological processes targeted by the intervention were improved, together with the mindfulness trait. At the symptom-based level, we observed a significant reduction in substance abuse and emotional symptoms. Treatment gains were maintained at follow-up. From a process-based perspective, this result implies that the intervention successfully targeted the psychological processes underlying the presenting symptoms. Adopting a process-based approach rather than symptom- or syndrome-based approaches is a valuable alternative in the conceptualization and treatment of complex cases presenting with multiple comorbidities.
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Affiliation(s)
| | - Joël Billieux
- Institute of Psychology, University of Lausanne (UNIL), Lausanne, Switzerland.,Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
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Gawron L, Pohl A, Gerlach AL. The Influence of Alcohol on Rumination and Metacognitions in Major Depressive Disorder. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e5615. [PMID: 36762347 PMCID: PMC9881120 DOI: 10.32872/cpe.5615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 09/16/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Objectives Comorbidity between major depressive disorder (MDD) and alcohol use disorder (AUD) is highly prevalent but reasons for this association are unclear. Rumination may activate metacognitive beliefs that contribute to the development and maintenance of rumination and depression. Negative metacognitions can further lead to other dysfunctional coping strategies (i.e., consumption of alcohol). We examined whether alcohol reduces (state) metacognitions, rumination and other disorder-specific processes in a group of individuals suffering from MDD. Method In an experiment with three randomized conditions we investigated whether the consumption of alcohol, placebo or no alcohol (orange juice) affects (meta-)cognitions, depressive symptoms and / or psychophysiological variables while participants ruminate. Results Voluntary rumination increased self-reported sadness, tension and rumination, tensed facial muscles and increased heart rate, but did not affect (state) metacognitions and heart rate variability. The consumption of alcohol did not influence rumination, metacognitions, depressive or psychophysiological measures. Limitations We recruited a depressed population but excluded pathological alcohol use due to ethical considerations. Conclusions We found no evidence that alcohol consumption affects rumination, metacognitions and other disorder-specific processes in MDD. However, rumination had a negative effect on various depression-specific processes, although it did not activate (negative state) metacognitions.
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Affiliation(s)
- Lana Gawron
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Anna Pohl
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
| | - Alexander L. Gerlach
- Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany
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Sánchez-Puertas R, Ruisoto P, López-Núñez C, Vaca-Gallegos S. Gender Differences in Transdiagnostic Predictors of Problematic Alcohol Consumption in a Large Sample of College Students in Ecuador. Front Psychol 2022; 13:784896. [PMID: 35282216 PMCID: PMC8907652 DOI: 10.3389/fpsyg.2022.784896] [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: 09/28/2021] [Accepted: 01/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background Alcohol use is one of the main risk factors that leads to detrimental health effects and support for a transdiagnostic approach to alcohol use disorders is growing. However, the role of transdiagnostic predictors of problematic alcohol consumption in Ecuador are understudied. Objective The aim of this study was to examine gender differences in psychological stress and inflexibility as transdiagnostic predictors of problematic alcohol consumption in a large sample of college students in Ecuador. Methods A total of 7,905 college students (21.49 years, SD = 3.68; 53.75% females) were surveyed using the following standardized scales: Alcohol Use Disorders Identification Test, Perceived Stress Scale-14, and Acceptance and Action Questionnaire (AAQ-7). Macro Process for SPSS (models 4 and 7) was used to analyze mediation and moderation effects. Results Reported alcohol consumption was significantly higher in men than women students. On the other hand, women reported significantly higher levels of perceived stress and psychological inflexibility than men students. Gender, age, psychological stress, and inflexibility were significant predictors of alcohol consumption. Moreover, psychological inflexibility mediated the impact of stress on alcohol consumption, particularly in women (for men b = 0.065, 95% CI [0.048 to 0.083], for women b = 0.070, 95% CI [0.051 to 0.089]). Discussion Results of this study support psychological stress and psychological inflexibility as critical transdiagnostic variables related to increased rates of alcohol consumption among Ecuadorian college students. These conclusions contribute to the development of transdiagnostic comprehensive programs, which encompasses promotive, preventive, and treatment services that allow to alleviate the burden of alcohol, as well as to enrich the growing research on alcohol consumption in this population from a gender perspective.
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Affiliation(s)
- Rafael Sánchez-Puertas
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain.,Department of Psychology, Universidad Técnica Particular de Loja, Loja, Ecuador
| | - Pablo Ruisoto
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain
| | - Carla López-Núñez
- Department of Personality, Assessment and Psychological Treatments, School of Psychology, University of Seville, Seville, Spain
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Brailovskaia J, Stirnberg J, Rozgonjuk D, Margraf J, Elhai JD. From low sense of control to problematic smartphone use severity during Covid-19 outbreak: The mediating role of fear of missing out and the moderating role of repetitive negative thinking. PLoS One 2021; 16:e0261023. [PMID: 34936651 PMCID: PMC8694423 DOI: 10.1371/journal.pone.0261023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/22/2021] [Indexed: 11/24/2022] Open
Abstract
Since the outbreak of Covid-19, the use of digital devices, especially smartphones, remarkably increased. Smartphone use belongs to one's daily routine, but can negatively impact physical and mental health, performance, and relationships if used excessively. The present study aimed to investigate potential correlates of problematic smartphone use (PSU) severity and the mechanisms underlying its development. Data of 516 smartphone users from Germany (Mage = 31.91, SDage = 12.96) were assessed via online surveys in April and May 2021. PSU severity was significantly negatively associated with sense of control. In contrast, it was significantly positively linked to fear of missing out (FoMO), repetitive negative thinking (RNT), and daily time spent on smartphone use. In a moderated mediation analysis, the negative relationship between sense of control and PSU severity was significantly mediated by FoMO. RNT significantly moderated the positive association between FoMO and PSU severity. Specifically, the higher the RNT, the stronger the relationship between FoMO and PSU. The present findings disclose potential mechanisms that could contribute to PSU. Potential ways of how to reduce PSU severity are discussed.
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Affiliation(s)
- Julia Brailovskaia
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Jan Stirnberg
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Dmitri Rozgonjuk
- Department of Molecular Psychology, Ulm University, Ulm, Germany
- Institute of Mathematics and Statistics, University of Tartu, Tartu, Estonia
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Department of Clinical Psychology and Psychotherapy, Ruhr-Universität Bochum, Bochum, Germany
| | - Jon D. Elhai
- Department of Psychology, University of Toledo, Toledo, Ohio, United States of America
- Department of Psychiatry, University of Toledo, Toledo, Ohio, United States of America
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8
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Hummel KV, Trautmann S, Venz J, Thomas S, Schäfer J. Repetitive negative thinking: transdiagnostic correlate and risk factor for mental disorders? A proof-of-concept study in German soldiers before and after deployment to Afghanistan. BMC Psychol 2021; 9:198. [PMID: 34924023 PMCID: PMC8686273 DOI: 10.1186/s40359-021-00696-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Disorder-specific forms of Repetitive Negative Thinking (RNT) are associated with multiple diagnostic categories, indicating a transdiagnostic nature. Few studies examined content-independent RNT processes across groups of diagnosed mental disorders. Moreover, theory describes RNT processes as critically involved in the etiology of mental disorders, empirical evidence however is scarce. We first tested the transdiagnostic nature by examining levels of RNT across groups of internalizing and externalizing mental disorders compared to healthy individuals and explored RNT levels in a comorbid disorder-group. Second, we examined whether RNT predicts incident psychopathology. METHODS In a sample of German soldiers (n = 425) scheduled for deployment in Afghanistan, we compared RNT levels between diagnosed groups with alcohol use disorders, anxiety disorders and healthy individuals cross-sectionally. Exploratory analyses were conducted comparing a comorbid disorder-group to healthy individuals and to both single-disorder-groups. Longitudinally, we examined the predictive value of pre-deployment RNT levels for incident psychopathology after deployment (n = 167). RNT was measured using the Perseverative Thinking Questionnaire (PTQ), DSM-IV diagnoses were assessed using the standardized Composite International Diagnostic Interview (CIDI). RESULTS Cross-sectional comparisons revealed that soldiers with alcohol use disorders and anxiety disorders showed significantly higher degrees of RNT compared to healthy soldiers. RNT levels in those with comorbid disorders were significantly higher compared to healthy soldiers but also compared to both single-disorder-groups. Longitudinal analyses revealed that higher levels of RNT prior to deployment were associated with a higher risk to have any incidental mental disorder after deployment. This however is only attributable to individuals with a PTQ score above a cut-off of 15. CONCLUSIONS Findings provide evidence for RNT as a transdiagnostic correlate and a vulnerability factor for the development of mental disorders.
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Affiliation(s)
- Katrin V Hummel
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | | | - John Venz
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Sarah Thomas
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany
| | - Judith Schäfer
- Department of Psychology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. 46, 01187, Dresden, Germany.
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Hamonniere T, Milan L, Varescon I. Repetitive negative thinking, metacognitive beliefs, and their interaction as possible predictors for problematic cannabis use. Clin Psychol Psychother 2021; 29:706-717. [PMID: 34431580 DOI: 10.1002/cpp.2664] [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: 05/12/2021] [Revised: 07/12/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022]
Abstract
The metacognitive formulation of addictive behaviours considers repetitive negative thinking (RNT) and metacognitive beliefs as two important processes involved in the development and maintenance of addictive behaviours. To date, very limited research has investigated the implication of these processes in problematic cannabis use. The present study was aimed at exploring the association between RNT, metacognitive beliefs, and cannabis use in a sample of 157 problematic cannabis users. Participants were administered measures of cannabis use severity, RNT, metacognitive beliefs, anxiety, and depression. Multiple regression analysis showed that metacognitive beliefs (cognitive confidence, beliefs about the need to control thought, and cognitive self-consciousness) were independent predictors of problematic cannabis use and related problem severity when controlling for RNT and negative affect (anxiety and depression). Furthermore, RNT predicted problematic cannabis use severity only for users with low levels of negative beliefs about thoughts concerning uncontrollability and danger. These data suggest that metacognitive beliefs and RNT may be two relevant cognitive processes for understanding problematic cannabis use. More generally, it enables the consideration of cannabis use from the perspective of self-regulation theories, and more specifically cognitive regulation, thus offering several theoretical and clinical implications.
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Affiliation(s)
- Tristan Hamonniere
- LPPS, Université de Paris, Boulogne-Billancourt, France.,Clinique Médicale et Pédagogique Dupré, Fondation Santé des Étudiants de France, Sceaux, France
| | - Lena Milan
- LPPS, Université de Paris, Boulogne-Billancourt, France
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Schettino M, Ghezzi V, Ang YS, Duda JM, Fagioli S, Mennin DS, Pizzagalli DA, Ottaviani C. Perseverative Cognition in the Positive Valence Systems: An Experimental and Ecological Investigation. Brain Sci 2021; 11:brainsci11050585. [PMID: 33946423 PMCID: PMC8147166 DOI: 10.3390/brainsci11050585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022] Open
Abstract
Perseverative cognition (PC) is a transdiagnostic risk factor that characterizes both hypo-motivational (e.g., depression) and hyper-motivational (e.g., addiction) disorders; however, it has been almost exclusively studied within the context of the negative valence systems. The present study aimed to fill this gap by combining laboratory-based, computational and ecological assessments. Healthy individuals performed the Probabilistic Reward Task (PRT) before and after the induction of PC or a waiting period. Computational modeling was applied to dissociate the effects of PC on reward sensitivity and learning rate. Afterwards, participants underwent a one-week ecological momentary assessment of daily PC occurrence, as well as anticipatory and consummatory reward-related behavior. Induction of PC led to increased response bias on the PRT compared to waiting, likely due to an increase in learning rate but not in reward sensitivity, as suggested by computational modeling. In daily-life, PC increased the discrepancy between expected and obtained rewards (i.e., prediction error). Current converging experimental and ecological evidence suggests that PC is associated with abnormalities in the functionality of positive valence systems. Given the role of PC in the prediction, maintenance, and recurrence of psychopathology, it would be clinically valuable to extend research on this topic beyond the negative valence systems.
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Affiliation(s)
- Martino Schettino
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Correspondence: (M.S.); (C.O.)
| | - Valerio Ghezzi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Yuen-Siang Ang
- Department of Social and Cognitive Computing, Institute of High Performance Computing, Agency for Science, Technology and Research, Singapore 138632, Singapore;
| | - Jessica M. Duda
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA; (J.M.D.); (D.A.P.)
| | - Sabrina Fagioli
- Department of Education, University of Roma Tre, 00185 Rome, Italy;
| | | | - Diego A. Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA 02478, USA; (J.M.D.); (D.A.P.)
- Department of Psychiatry, Harvard Medical School, Belmont, MA 02115, USA
| | - Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy;
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Correspondence: (M.S.); (C.O.)
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Mollaahmetoglu OM, Palmer E, Maschauer E, Nolan MC, Stevens T, Carlyle M, Hardy L, Watkins ER, Morgan CJA. The acute effects of alcohol on state rumination in the laboratory. Psychopharmacology (Berl) 2021; 238:1671-1686. [PMID: 33635385 PMCID: PMC8139935 DOI: 10.1007/s00213-021-05802-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
RATIONALE Rumination is a repetitive, negative, self-focused thinking style associated with various forms of psychopathology. Recent studies suggest that rumination increases craving for alcohol and predicts harmful drinking and alcohol-related problems. However, the acute effects of alcohol on rumination have not been previously studied. It is proposed that alcohol may reduce ruminative thinking through decreasing negative mood. OBJECTIVES In the present study, we aimed to test the previously unexplored effects of acute alcohol consumption on rumination in a hazardous drinking population. METHODS We conducted a randomised placebo-controlled laboratory study to examine the effect of low (0.4 g kg-1) and high doses (0.8 g kg-1) of alcohol on state rumination compared to placebo. Participants completed a rumination induction task prior to receiving drinks. We then measured state rumination and mood at repeated time points; 30 min, 60 min and 90 min post-drinks consumption. RESULTS We found a significant decrease in state rumination in the low-dose alcohol group compared to placebo at 30 min post-alcohol consumption, but no difference was observed between the high-dose alcohol and placebo groups. Mediation analysis provided evidence for an indirect effect of alcohol on state rumination through concurrent changes in negative mood. CONCLUSIONS These findings suggest that acute alcohol consumption can regulate negative mood and concurrently rumination, providing preliminary evidence for the role of rumination in alcohol use disorders. Rumination may be a treatment target in alcohol use disorders.
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Affiliation(s)
- O. Merve Mollaahmetoglu
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Edward Palmer
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Emily Maschauer
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Melissa C. Nolan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Tobias Stevens
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Molly Carlyle
- School of Psychology, University of Queensland, St. Lucia, QLD Australia
| | - Lorna Hardy
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Edward R. Watkins
- SMART Lab, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
| | - Celia J. A. Morgan
- Psychopharmacology and Addiction Research Centre (PARC), University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG UK
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Sorid SD, Wedell E, Herchenroeder L, Bravo AJ. Anxiety Symptoms and Alcohol-Related Problems among College Students: A Moderated-Mediation Model of Rumination and Emotion Dysregulation. Subst Use Misuse 2021; 56:471-478. [PMID: 33587015 DOI: 10.1080/10826084.2021.1879146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Prior research has individually linked rumination, anxiety, and emotion dysregulation to alcohol misuse, but limited research has examined a comprehensive model linking these variables together. The present study tested a moderated-mediation model to examine whether emotion dysregulation moderated the indirect association of anxiety symptoms on alcohol-related problems via ruminative thinking styles. Method: Participants were 448 college students who consumed alcohol in the previous month. A plurality of participants identified as being White, non-Hispanic (40.6%), female (68.6%), and reported a mean age of 22.75 (Median = 20.00; SD = 6.84) years. Results: Brooding and reflection subtypes of ruminative thinking mediated the association between anxiety symptoms and alcohol-related problems with higher rates of anxiety symptoms associated with higher ruminative thinking, which in turn was associated with more alcohol-related problems. Further, the indirect effect of anxiety symptoms on alcohol-related problems through ruminative thinking was stronger for individuals who reported high levels of emotion dysregulation compared to those with average and low levels of emotion dysregulation. Conclusions: In support of prior work, our results suggest that ruminative thinking, particularly brooding and reflection, are key mechanisms through which anxiety symptoms relate to problematic alcohol use, especially among individuals with high emotion dysregulation. Additional work is needed to test whether decoupling the associations between negative emotional states and ruminative thinking among college students with high emotion dysregulation is a viable intervention target to reduce problematic alcohol use.
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Affiliation(s)
| | - Emma Wedell
- Department of Psychological Sciences, William & Mary, USA
| | | | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, USA
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Hamonniere T, Laqueille X, Vorspan F, Dereux A, Illel K, Varescon I. Toward a better understanding of the influence of repetitive negative thinking in alcohol use disorder: An examination of moderation effect of metacognitive beliefs and gender. Addict Behav 2020; 111:106561. [PMID: 32739590 DOI: 10.1016/j.addbeh.2020.106561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 01/01/2023]
Abstract
Repetitive negative thinking (RNT), the most studied forms of which are depressive ruminations and anxious worry, is a unique transdiagnostic process responsible for the development and maintenance of many mental disorders. Over the past decade, studies have shown that RNT could be involved in the development and maintenance of alcohol use disorder (AUD). However, to date, little is known about the factors that can influence this relationship, even though some theoretical and empirical arguments suggest that variables such as gender or metacognitive beliefs may determine the role of RNT in the onset of symptoms. The aim of the present study was to test the moderation effect of metacognitive beliefs and gender in the relationship between RNT and AUD. Eighty-one AUD patients were administered measures of AUD severity, RNT, metacognitive beliefs about thinking and alcohol use, anxiety, and depression. Results indicated that the 'capture mental resources' factor of RNT is a significant predictor of AUD severity, independent from anxiety and depression, and that this effect is moderated by metacognitive beliefs and gender. RNT is a significant predictor of AUD severity only for people with high negative beliefs about thoughts regarding uncontrollability and danger. Furthermore, RNT was found to predict AUD severity only for men with high beliefs about the need to control thoughts and for men with high positive beliefs about emotional self-regulation. Treatments that reduce attentional impairments caused by RNT and modify dysfunctional metacognitive beliefs could be promising for some patients with AUD.
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Affiliation(s)
- Tristan Hamonniere
- Université de Paris, LPPS, F-92100 Boulogne-Billancourt, France; Clinique Médical et Pédagogique Dupré, Fondation Santé des Étudiants de France, Sceaux, France.
| | - Xavier Laqueille
- Service d'Addictologie « Moreau de Tours », Centre Hospitalier Sainte Anne, GHU Paris Psychiatrie & Neurosciences, Paris, France; Faculté de Médecine, Université de Paris, Site Cochin, 75014 Paris, France
| | - Florence Vorspan
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP.NORD, 200 rue du Fg St Denis, 75010 Paris, France; Faculté de Médecine, Université de Paris, Site Villemin, 75010 Paris, France; INSERM UMRS 1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, 75006 Paris, France
| | - Alexandra Dereux
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, APHP.NORD, 200 rue du Fg St Denis, 75010 Paris, France; INSERM UMRS 1144 Optimisation Thérapeutique en Neuropsychopharmacologie, Université de Paris, 75006 Paris, France
| | - Katia Illel
- Service d'Addictologie « Moreau de Tours », Centre Hospitalier Sainte Anne, GHU Paris Psychiatrie & Neurosciences, Paris, France
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Ballesio A, Bacaro V, Vacca M, Chirico A, Lucidi F, Riemann D, Baglioni C, Lombardo C. Does cognitive behaviour therapy for insomnia reduce repetitive negative thinking and sleep-related worry beliefs? A systematic review and meta-analysis. Sleep Med Rev 2020; 55:101378. [PMID: 32992228 DOI: 10.1016/j.smrv.2020.101378] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 11/19/2022]
Abstract
Repetitive negative thinking (RNT), i.e., worry, rumination, and transdiagnostic repetitive thinking, is thought to exacerbate and perpetuate insomnia in cognitive models. Moreover, RNT is a longitudinal precursor of depression and anxiety, which are often co-present alongside insomnia. Whilst accumulating evidence supports the efficacy of cognitive behavioural therapy for insomnia (CBT-I) in reducing depression and anxiety symptoms, the literature on the effects of CBT-I on RNT has never been systematically appraised. Importantly, preliminary evidence suggests that reduction of RNT following CBT-I may be associated with reduction of depression and anxiety. Therefore, we aimed to conduct a systematic review and meta-analysis on the effects of CBT-I on RNT. Seven databases were searched, and 15 randomised controlled trials were included. Results showed moderate-to-large effects of CBT-I on worry (Hedge's g range: -0.41 to g = -0.71) but small and non-reliable effects on rumination (g = -0.13). No clear evidence was found for an association between post-treatment reduction in RNT and post-treatment reduction in depression and anxiety. Although the literature is small and still developing, CBT-I seems to have a stronger impact on sleep-related versus general measures of RNT. We discuss a research agenda aimed at advancing the study of RNT in CBT-I trials.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Italy; Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.
| | - Valeria Bacaro
- Department of Human Sciences, University of Rome "G. Marconi"- Telematic, Italy
| | | | - Andrea Chirico
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Fabio Lucidi
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - Chiara Baglioni
- Department of Human Sciences, University of Rome "G. Marconi"- Telematic, Italy; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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