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Kuczynski AM, Piccirillo ML, Dora J, Kuehn KS, Halvorson MA, King KM, Kanter JW. Characterizing the momentary association between loneliness, depression, and social interactions: Insights from an ecological momentary assessment study. J Affect Disord 2024; 360:376-386. [PMID: 38823593 DOI: 10.1016/j.jad.2024.05.148] [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: 01/15/2024] [Revised: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and ∼2.5h and ∼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention.
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Kuehn KS, Piccirillo ML, Kuczynski AM, King KM, Depp CA, Foster KT. Person-specific dynamics between negative emotions and suicidal thoughts. Compr Psychiatry 2024; 133:152495. [PMID: 38728844 DOI: 10.1016/j.comppsych.2024.152495] [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: 01/12/2024] [Revised: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Recent technology has enabled researchers to collect ecological momentary assessments (EMA) to examine within-person correlates of suicidal thoughts. Prior studies examined generalized temporal dynamics of emotions and suicidal thinking over brief periods, but it is not yet known how variable these processes are across people. METHOD We use data EMA data delivered over two weeks with youth/young adults (N = 60) who reported past year self-injurious thoughts/behaviors. We used group iterative multiple model estimation (GIMME) to model group- and person-specific associations of negative emotions (i.e., fear, sadness, shame, guilt, and anger) and suicidal thoughts. RESULTS 29 participants (48.33%) reported at least one instance of a suicidal thought and were included in GIMME models. In group level models, we consistently observed autoregressive effects for suicidal thoughts (e.g., earlier thoughts predicting later thoughts), although the magnitude and direction of this link varied from person-to-person. Among emotions, sadness was most frequently associated with contemporaneous suicidal thoughts, but this was evident for less than half of the sample, while other emotional correlates of suicidal thoughts broadly differed across people. No emotion variable was linked to future suicidal thoughts in >14% of the sample, CONCLUSIONS: Emotion-based correlates of suicidal thoughts are heterogeneous across people. Better understanding of the individual-level pathways maintaining suicidal thoughts/behaviors may lead to more effective, personalized interventions.
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Dora J, Kuczynski AM, Schultz ME, Acuff SF, Murphy JG, King KM. An experimental investigation into the effect of negative affect on the behavioral economic demand for alcohol. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:409-423. [PMID: 38190199 DOI: 10.1037/adb0000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
OBJECTIVE It is hypothesized that alcohol use is reinforcing when used as a strategy to cope with negative affect. Although the evidence for this hypothesis in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. We hypothesized that people show a higher demand for alcohol following negative (vs. neutral) mood inductions and that this effect is stronger in people who report heavier drinking compared to people who report lighter drinking as well as stronger on days characterized by higher coping motives and negative urgency. METHOD 309 college students who reported recent alcohol consumption (MAUDIT = 6.86) completed the alcohol purchase task after being subjected to 12 mood inductions (six negative, six neutral, order randomized) on 12 separate days. RESULTS In our preregistered analyses, we found no evidence that the behavioral economic demand for alcohol was elevated following negative mood inductions. The mood inductions in our study were not as strong as has been reported in previous research, weakening the preregistered inferences. In exploratory analyses performed on a subset of the data in which the mood inductions worked as intended, demand was higher following negative mood inductions. CONCLUSIONS The results of this study are not conclusive. In light of previous research, we consider these data to slightly increase our confidence that demand for alcohol is increased immediately following a negative emotional event. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Dora J, Kuczynski AM, Schultz ME, Acuff SF, Murphy JG, King KM. An experimental investigation into the effect of negative affect on the behavioral economic demand for alcohol. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:1-7. [PMID: 35201808 PMCID: PMC10759813 DOI: 10.1037/adb0000823] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Influential theoretical models hypothesize that alcohol use is an especially potent reinforcer when used as a strategy to cope with negative affect. Although the evidence for this idea in observational data is weak, some experimental evidence suggests that the behavioral economic demand for alcohol increases immediately following a negative emotional event. Because existing studies testing the effect of negative mood inductions on the demand for alcohol have several methodological limitations and do not take inter- and intraindividual variability into account, we developed an improved experimental design to increase our confidence in any potential within-person effect of negative mood inductions on alcohol demand as well as to test whether this effect exhibits systematic inter- and intraindividual variability. We hypothesize that people will show a higher demand for alcohol following negative compared to neutral mood inductions and that this effect is stronger in heavy compared to light drinkers as well as stronger on days characterized by higher coping motives and negative urgency. Three hundred twenty college students will complete the alcohol purchase task (APT) after being subjected to 100 mood inductions (six negative, six neutral) on 20 separate days. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Dora J, Smith MR, Seldin K, Schultz ME, Kuczynski AM, Moss DJ, Carpenter RW, King KM. Exploring associations between affect and marijuana use in everyday life via specification curve analysis. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:461-474. [PMID: 37036695 PMCID: PMC10164094 DOI: 10.1037/abn0000825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Although frequently hypothesized, the evidence for associations between affect and marijuana use in everyday life remains ambiguous. Inconsistent findings across existing work may be due, in part, to differences in study design and analytic decisions, such as study inclusion criteria, the operationalization of affect, or the timing of affect assessment. We used specification curves to assess the robustness of the evidence for affect predicting same-day marijuana use and marijuana use predicting next-day affect across several hundred models that varied in terms of decisions that reflect those typical in this literature (e.g., whether to average affect prior to marijuana use or select the affect report closest in time to marijuana use). We fitted these curves to data from two ecological momentary assessment studies of regular marijuana and/or alcohol using college students (N = 287). Results provided robust evidence that marijuana use was slightly less likely following experiences of negative affect and slightly more likely following positive affect. Specification curves suggested that differences in previous findings are most likely a function of the specific emotion items used to represent affect rather than differences in inclusion criteria, the temporal assessment and modeling of affect, or the covariates added to the model. There was little evidence for an association between marijuana use and next-day affect. Overall, our findings provide evidence against the predictions made by affect reinforcement models in college students and suggest that future research should model the associations of marijuana use with discrete emotional states rather than general negative and positive affect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Dora J, Piccirillo M, Foster KT, Arbeau K, Armeli S, Auriacombe M, Bartholow B, Beltz AM, Blumenstock SM, Bold K, Bonar EE, Braitman A, Carpenter RW, Creswell KG, De Hart T, Dvorak RD, Emery N, Enkema M, Fairbairn C, Fairlie AM, Ferguson SG, Freire T, Goodman F, Gottfredson N, Halvorson M, Haroon M, Howard AL, Hussong A, Jackson KM, Jenzer T, Kelly DP, Kuczynski AM, Kuerbis A, Lee CM, Lewis M, Linden-Carmichael AN, Littlefield A, Lydon-Staley DM, Merrill JE, Miranda R, Mohr C, Read JP, Richardson C, O’Connor R, O’Malley SS, Papp L, Piasecki TM, Sacco P, Scaglione N, Serre F, Shadur J, Sher KJ, Shoda Y, Simpson TL, Smith MR, Stevens A, Stevenson B, Tennen H, Todd M, Treloar Padovano H, Trull T, Waddell J, Walukevich-Dienst K, Witkiewitz K, Wray T, Wright AG, Wycoff AM, King KM. The daily association between affect and alcohol use: A meta-analysis of individual participant data. Psychol Bull 2023; 149:1-24. [PMID: 37560174 PMCID: PMC10409490 DOI: 10.1037/bul0000387] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.
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Kanter JW, Kuczynski AM, Manbeck KE, Corey MD, Wallace EC. An integrative contextual behavioral model of intimate relations. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Kuczynski AM, Kanter JW, Wetterneck CT, Olaz FO, Singh RS, Lee EB, Stowe TJ, Mazzucchelli TG, Mier-Chairez J, Maitland DW, Manbeck KE, Corey MD. Measuring intimacy as a contextual behavioral process: Psychometric development and evaluation of the Awareness, Courage, and Responsiveness Scale. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kanter JW, Rosen DC, Manbeck KE, Branstetter HML, Kuczynski AM, Corey MD, Maitland DWM, Williams MT. Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial. BMC MEDICAL EDUCATION 2020; 20:88. [PMID: 32209082 PMCID: PMC7092438 DOI: 10.1186/s12909-020-02004-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 03/13/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters. METHODS This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers' likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants. RESULTS Greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants. CONCLUSIONS Medical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.
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Kuczynski AM, Kanter JW, Robinaugh DJ. Differential associations between interpersonal variables and quality-of-life in a sample of college students. Qual Life Res 2019; 29:127-139. [PMID: 31535262 DOI: 10.1007/s11136-019-02298-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Humans are fundamentally social beings, and the relationships we form with others are crucial for our well-being. Research across a variety of domains has established the association between a variety of interpersonal factors and health outcomes, including quality-of-life. However, there is a need for a more integrative, holistic analysis of these variables and how they relate to one another. METHODS Undergraduate students (n = 1456) from four universities across the United States completed self-report measures of their quality-of-life and a variety of interpersonal factors identified as important predictors across the literature. We examined zero-order correlations between these measures and quality-of-life, estimated a path model to look at unique variance accounted for by each, and finally used network analysis to examine the network of direct and indirect associations among these variables and quality-of-life. RESULTS Loneliness had the strongest association with quality-of-life across all analyses. When examining the unique association between quality-of-life and each interpersonal variable, six remained statistically significant: loneliness, social support, social connectedness, emotional intelligence, intimacy with one's romantic partner, and empathic concern. These results were supported by the network model, which found direct associations between quality-of-life and these six variables as well as indirect associations with all other interpersonal variables in the model. CONCLUSIONS Results from this research suggest that interpersonal factors in general, and loneliness in particular, are strongly associated with quality-of-life. Future research is needed to establish the direction of these effects and examine for whom these findings are generalizable.
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Manbeck KE, Kanter JW, Kuczynski AM, Fine L, Corey MD, Maitland DW. Improving relations among conservatives and liberals on a college campus: A preliminary trial of a contextual-behavioral intervention. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kanter JW, Manbeck KE, Kuczynski AM, Maitland DW, Villas-Bôas A, Reyes Ortega MA. A comprehensive review of research on Functional Analytic Psychotherapy. Clin Psychol Rev 2017; 58:141-156. [DOI: 10.1016/j.cpr.2017.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 09/20/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
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Haworth K, Kanter JW, Tsai M, Kuczynski AM, Rae JR, Kohlenberg RJ. Reinforcement matters: A preliminary, laboratory-based component-process analysis of Functional Analytic Psychotherapy’s model of social connection. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kohlenberg RJ, Tsai M, Kuczynski AM, Rae JR, Lagbas E, Lo J, Kanter JW. A brief, interpersonally oriented mindfulness intervention incorporating Functional Analytic Psychotherapy׳s model of awareness, courage and love. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2015. [DOI: 10.1016/j.jcbs.2015.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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