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Walsh BE, Dvorak RD, Ebbinghaus A, Gius BK, Levine JA, Cortina W, Schlauch RC. Disaggregating within- and between-person effects of affect on drinking behavior in a clinical sample with alcohol use disorder. J Psychopathol Clin Sci 2023; 132:1051-1059. [PMID: 38010773 PMCID: PMC10683873 DOI: 10.1037/abn0000875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE The goal of the current study was to better understand affect-drinking relations among those diagnosed with an alcohol use disorder (AUD), as recent meta-analytic work suggests that daily negative affect may not universally predict subsequent alcohol consumption in those nondependent on alcohol. Specifically, we investigated the between- and within-person effects of positive and negative affects on drinking. METHOD Participants (n = 92) who met AUD diagnostic criteria completed a 90-day daily assessment of drinking behavior and positive and negative affects. RESULTS Time-lagged multilevel modeling revealed that within-person elevations in negative affect predicted increased odds and quantity of drinking later in the day. Relations between positive affect and drinking were nonsignificant. CONCLUSIONS These findings are in contrast to recent meta-analytic findings and highlight the complexity of affect-drinking relations among those diagnosed with AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Becky K. Gius
- Department of Psychology, University of South Florida
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Gius BK, Fournier LF, Reljic T, Pogoda TK, Corrigan JD, Garcia A, Troyanskaya M, Hodges CB, Miles SR. Associations Between Sociodemographic, Mental Health, and Mild Traumatic Brain Injury Characteristics With Lifetime History of Criminal Justice Involvement in Combat Veterans and Service Members. Mil Med 2023; 188:e3143-e3151. [PMID: 36029468 DOI: 10.1093/milmed/usac257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Veterans and service members (V/SM) may have more risk factors for arrest and felony incarceration (e.g., posttraumatic stress disorder and at-risk substance use) but also more protective factors (e.g., access to health care) to mitigate behaviors that may lead to arrest. As such, understanding which factors are associated with criminal justice involvement among V/SM could inform prevention and treatment efforts. The current study examined relationships between lifetime history of arrests and felony incarceration and sociodemographic, psychological, and brain injury characteristics factors among combat V/SM. MATERIALS AND METHODS The current study was a secondary data analysis from the Chronic Effects of Neurotrauma Consortium multicenter cohort study, approved by local institutional review boards at each study site. Participants were V/SM (N = 1,540) with combat exposure (19% active duty at time of enrollment) who were recruited from eight Department of Veterans Affairs and DoD medical centers and completed a baseline assessment. Participants were predominantly male (87%) and white (72%), with a mean age of 40 years (SD = 9.7). Most (81%) reported a history of at least one mild traumatic brain injury, with one-third of those experiencing three or more mild traumatic brain injuries (33%). Participants completed a self-report measure of lifetime arrest and felony incarceration history, a structured interview for all potential concussive events, the post-traumatic stress disorder checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and the Alcohol Use Disorders Identification Test-Consumption. Three groups were compared on self-reported level of lifetime history of criminal justice system involvement: (1) no history of arrest or incarceration (65%); (2) history of arrest but no felony incarceration (32%); and (3) history of felony incarceration (3%). RESULTS Ordinal regression analyses revealed that hazardous alcohol consumption (β = .44, P < .001; odds ratio = 1.56) was positively associated with increased criminal justice involvement after adjusting for all other variables. Being married or partnered (β = -.44, P < .001; odds ratio = 0.64) was negatively associated with decreased criminal justice involvement. CONCLUSIONS The rate of lifetime arrest (35%) in this V/SM sample was consistent with rates of arrests in the U.S. general population. One modifiable characteristic associated with lifetime arrest and felony incarceration was hazardous alcohol consumption. Alcohol use should be a top treatment target for V/SM at risk for arrest and those with history of criminal justice involvement.
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Affiliation(s)
- Becky K Gius
- Department of Psychology, University of South Florida, Tampa, FL 33620, USA
- Mental Health and Behavioral Sciences Service, James A Haley Veterans' Hospital, Tampa, FL 33612, USA
| | - Lauren F Fournier
- Department of Psychology, University of South Florida, Tampa, FL 33620, USA
- Mental Health and Behavioral Sciences Service, James A Haley Veterans' Hospital, Tampa, FL 33612, USA
| | - Tea Reljic
- Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA
| | - Terri K Pogoda
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA 02118, USA
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH 43210, USA
| | - Amanda Garcia
- Traumatic Brain Injury Center of Excellence, James A Haley Veterans' Hospital, Tampa, FL 33612, USA
- 9Line, LLC, Tampa, FL 33609, USA
| | - Maya Troyanskaya
- Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX 77030, USA
| | - Cooper B Hodges
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Shannon R Miles
- Mental Health and Behavioral Sciences Service, James A Haley Veterans' Hospital, Tampa, FL 33612, USA
- Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
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Davis JA, Gius BK, Crane CA, Maisto SA, Schlauch RC. Pretreatment changes in drinking: Theoretical and methodological implications for alcohol use disorder treatment outcome research. Alcohol Clin Exp Res 2023; 47:1406-1420. [PMID: 37455388 DOI: 10.1111/acer.15120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 05/11/2023] [Accepted: 05/16/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND There is a growing recognition of the importance of changes in drinking prior to the first treatment session (i.e., pretreatment change). A major limitation of past studies of pretreatment change is the reliance on retrospective reporting on drinking rates between the baseline assessment and the first treatment session collected at the end of treatment. The present study sought to extend previous findings by examining 12-month treatment outcomes and correlates of pretreatment changes in drinking measured weekly during treatment. METHODS Data from a randomized behavioral clinical trial examining the effect of therapeutic alliance feedback on drinking outcomes were analyzed (n = 165). All participants received cognitive behavioral therapy for alcohol dependence, completed pre and posttreatment assessments, and provided weekly measures of drinking during treatment. RESULTS Results indicated that approximately half of the sample reduced their heavy drinking days by 70% or more and number of drinking days by 50% or more prior to beginning treatment. Further, individuals who reported greater consideration of how their problematic drinking affected their social environment displayed greater changes in drinking days prior to treatment. Changes in heavy drinking days were also related to relationship status, such that individuals who were single/never married were less likely to change prior to treatment than those who were married/cohabitating or separated/divorced. CONCLUSION These confirm the importance of pretreatment change in the study of treatment outcomes, and suggest that interpersonal processes, including the appraisal of drinking behavior in a social context, may play an important role in pretreatment changes in drinking.
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Affiliation(s)
- Jared A Davis
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Becky K Gius
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Cory A Crane
- Department of Biomedical Sciences, Rochester Institute of Technology, Rochester, New York, USA
| | - Stephen A Maisto
- Department of Psychology, Syracuse University, Syracuse, New York, USA
| | - Robert C Schlauch
- Department of Psychology, University of South Florida, Tampa, Florida, USA
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Levine JA, Gius BK, Boghdadi G, Connors GJ, Maisto SA, Schlauch RC. Reductions in Drinking Predict Increased Distress: Between- and Within-Person Associations between Alcohol Use and Psychological Distress During and Following Treatment. Alcohol Clin Exp Res 2020; 44:2326-2335. [PMID: 32945567 DOI: 10.1111/acer.14462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/07/2020] [Accepted: 09/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND As the nature of the association between alcohol use disorder (AUD) and other disorders is not well understood, the ways in which psychological distress changes during the course of treatment for AUD are relatively unknown. Existing literatures posit 2 competing hypotheses such that treatment for AUD concurrently decreases alcohol use and psychological distress or treatment for AUD decreases alcohol use and increases psychological distress. The current study examined the ways in which psychological distress changed as a function of treatment for AUD, including the relationship between psychological distress and drinking behaviors. METHODS Secondary data analysis was conducted on an existing clinical trial dataset that investigated the effect of cognitive-behavioral therapy and therapeutic alliance feedback on AUDs. Specifically, data collected at baseline, posttreatment, 3-month, 6-month, 9-month, and 12-month follow-up assessments were examined. RESULTS Results indicated decreases in heavy drinking days, increases in percentage of days abstinent, and decreases in overall psychological distress. Findings also revealed that changes in psychological distress did not predict changes in drinking at the next time interval; however, decreases in drinking predicted higher psychological distress at the next assessment. Further, average levels of psychological distress were positively associated with rates of drinking. CONCLUSIONS The current study provides some insight into how psychological distress changes during the course of treatment for AUD, including the relationship between changes in drinking and such symptoms. Future research should continue to explore these relationships, including the ways in which treatment efforts can address what may be seen as paradoxical effects.
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Affiliation(s)
- Jacob A Levine
- From the, Department of Psychology, (JAL, BKG, GB, RCS), University of South Florida, Tampa, Florida, USA
| | - Becky K Gius
- From the, Department of Psychology, (JAL, BKG, GB, RCS), University of South Florida, Tampa, Florida, USA
| | - George Boghdadi
- From the, Department of Psychology, (JAL, BKG, GB, RCS), University of South Florida, Tampa, Florida, USA
| | - Gerard J Connors
- Research Institute on Addictions, (GJC), University at Buffalo, Buffalo, New York, USA
| | - Stephen A Maisto
- Department of Psychology, (SAM), Syracuse University, Syracuse, New York, USA
| | - Robert C Schlauch
- From the, Department of Psychology, (JAL, BKG, GB, RCS), University of South Florida, Tampa, Florida, USA
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Rodriguez LM, Gius BK, Derrick JL, Leonard KE. A dyadic approach to attachment anxiety and avoidance, marital conflict, and drinking. J Soc Pers Relat 2020; 37:2386-2408. [PMID: 33746328 PMCID: PMC7978435 DOI: 10.1177/0265407520922612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In this research, we integrate attachment theory and dyadic methodology to examine how attachment anxiety and avoidance might interact with marital conflict to influence alcohol consumption, drinking motives, and alcohol-related problems in a sample of 280 married and cohabiting couples over 3 years. Both husband and wife attachment anxiety were related to higher levels of own drinking to cope and alcohol-related problems. Additionally, both husband and wife reports of marital conflict were associated with own alcohol-related problems. For wives, significant interactions between anxiety and marital conflict suggested that anxiety was more strongly associated with alcohol consumption, coping, and problems at higher levels of conflict. For husbands, significant interactions between avoidance and conflict indicated that avoidance was more strongly associated with coping and problems at lower levels of conflict. This research suggests two main patterns of attachment and alcohol use, both exacerbated by marital conflict and different for husbands and wives.
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Levine JA, Noyes ET, Gius BK, Ahlich E, Rancourt D, Houston RJ, Schlauch RC. Development and Psychometric Evaluation of a Brief Approach and Avoidance of Alcohol Questionnaire. Alcohol Clin Exp Res 2018; 43:353-366. [PMID: 30549288 DOI: 10.1111/acer.13939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 12/05/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Approach and Avoidance of Alcohol Questionnaire (AAAQ) was developed as a measure of craving to assess both desires to consume and desires to avoid consuming alcohol. Although the measure has been used in a variety of populations to predict future alcohol use behavior, the factor structures observed vary based on sample type (e.g., clinical vs. college samples) and may be overly long for use in repeated measures designs. The current article describes the development of a brief version of the AAAQ for use in clinical populations. METHODS Using existing data sets of individuals in treatment for alcohol use disorder, exploratory analyses (e.g., exploratory factor analysis and item response theory) were conducted using an inpatient sample (N = 298) at a substance abuse treatment facility. Confirmatory analyses (e.g., confirmatory factor analysis and multiple regression) were conducted using an inpatient detoxification sample (N = 175) and a longitudinal outpatient treatment sample (N = 53). RESULTS The brief AAAQ had comparable internal consistency, explained a similar amount of variance in alcohol consumption and related problems, and exhibited superior model fit as compared to the original measure. CONCLUSIONS These findings indicate that the brief AAAQ is an effective tool to assess alcohol craving in clinical populations in treatment settings.
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Affiliation(s)
- Jacob A Levine
- Department of Psychology , University of South Florida, Tampa, Florida
| | - Emily T Noyes
- Department of Psychology , University of South Florida, Tampa, Florida
| | - Becky K Gius
- Department of Psychology , University of South Florida, Tampa, Florida
| | - Erica Ahlich
- Department of Psychology , University of South Florida, Tampa, Florida
| | - Diana Rancourt
- Department of Psychology , University of South Florida, Tampa, Florida
| | - Rebecca J Houston
- Department of Psychology , Health and Addictions Research Center, Rochester Institute of Technology, Rochester, New York
| | - Robert C Schlauch
- Department of Psychology , University of South Florida, Tampa, Florida
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