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Kiekens WJ, Parnes JE, Treloar Padovano H, Miranda R, Mereish EH. Momentary Minority Stress, Nicotine Use, and Craving: Moderation by Nicotine-Use Motives Among Sexual Minority Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024:1-13. [PMID: 39287970 DOI: 10.1080/15374416.2024.2395267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
OBJECTIVE This pre-registered analysis aimed to examine the moderating role of nicotine-use motives on the association between minority stress and nicotine use and craving among sexual minority youth. METHOD Data stem from a 30-day ecological momentary assessment study conducted among 83 sexual minority youth ages 15-19 years old (M age = 17.96, SD = 1.10; 56.63% cisgender women; 73.5% non-Hispanic White). Participants were instructed to complete at least four assessments per day on wireless devices. Two types of multilevel models were estimated: models predicting day-level nicotine use and models predicting momentary nicotine use craving. RESULTS Experiencing minority stressors was not associated with day-level nicotine use, but it was associated with greater momentary nicotine craving. Nicotine use-motives did not moderate the association between minority stress and nicotine use. In contrast, stress-reduction motives, assessed as a person-level trait, moderated the association between minority stress and nicotine craving, such that nicotine craving after experiencing a minority stressor was consistently higher relative to when minority stress had not been reported. Sensitivity analyses that examined associations between minority stress and nicotine use on a given day, regardless of temporal order, showed that minority stress was associated with higher odds of nicotine use on that day. CONCLUSIONS Experiencing minority stressors did not predict day-level nicotine use but does contribute to greater momentary nicotine craving, informing minority stress theory. Consistency of the minority stress and nicotine craving relation, largely regardless of trait-level motives, highlights the potential context dependence of nicotine craving among sexual minority youth.Preregistration: This study was preregistered at osf.io/w5sz9.
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Affiliation(s)
- Wouter J Kiekens
- Department of Sociology, (ICS) Interuniversity Center for Social Science Theory and Methodology, University of Groningen
| | - Jamie E Parnes
- Center for Alcohol and Addiction Studies, Brown University
| | | | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University
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Bortolato M, Braccagni G, Pederson CA, Floris G, Fite PJ. "Weeding out" violence? Translational perspectives on the neuropsychobiological links between cannabis and aggression. AGGRESSION AND VIOLENT BEHAVIOR 2024; 78:101948. [PMID: 38828012 PMCID: PMC11141739 DOI: 10.1016/j.avb.2024.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Recent shifts in societal attitudes towards cannabis have led to a dramatic increase in consumption rates in many Western countries, particularly among young people. This trend has shed light on a significant link between cannabis use disorder (CUD) and pathological reactive aggression, a condition involving disproportionate aggressive and violent reactions to minor provocations. The discourse on the connection between cannabis use and aggression is frequently enmeshed in political and legal discussions, leading to a polarized understanding of the causative relationship between cannabis use and aggression. However, integrative analyses from both human and animal research indicate a complex, bidirectional interplay between cannabis misuse and pathological aggression. On the one hand, emerging research reveals a shared genetic and environmental predisposition for both cannabis use and aggression, suggesting a common underlying biological mechanism. On the other hand, there is evidence that cannabis consumption can lead to violent behaviors while also being used as a self-medication strategy to mitigate the negative emotions associated with pathological reactive aggression. This suggests that the coexistence of pathological aggression and CUD may result from overlapping vulnerabilities, potentially creating a self-perpetuating cycle where each condition exacerbates the other, escalating into externalizing and violent behaviors. This article aims to synthesize existing research on the intricate connections between these issues and propose a theoretical model to explain the neurobiological mechanisms underpinning this complex relationship.
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Affiliation(s)
- Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, KS, USA
| | - Giulia Braccagni
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Casey A. Pederson
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gabriele Floris
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Center for Substance Abuse Research, Temple University, Philadelphia, PA, USA
- Department of Neural Sciences, Temple University, Philadelphia, PA, USA
| | - Paula J. Fite
- Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, KS, USA
- Clinical Child Psychology Program, University of Kansas, Lawrence, KS, USA
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Anderson GN, Conway CC, Bravo AJ. Distress tolerance is linked with substance use motivations and problems in young adults across four continents. J Pers 2024. [PMID: 39012203 DOI: 10.1111/jopy.12963] [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: 12/15/2023] [Revised: 05/20/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
INTRODUCTION People low in trait distress tolerance are at higher risk for harmful patterns of substance use. Some evidence suggests that maladaptive motives for substance use account for this correlation. However, the generality of these associations remains in doubt because virtually all available data come from North American samples. METHOD Using data from 7 countries (total N = 5858; U.S., Argentina, Uruguay, Spain, South Africa, Canada, and England), we examined distress tolerance's association with alcohol- and cannabis-related problems in young adults. On an exploratory basis, we examined how distress tolerance related to different substance-use motivations. RESULTS We found that distress tolerance was inversely related to problematic alcohol and cannabis use (rs = -0.14 and - 0.13). There was notable variation across countries in the magnitude of these effects, particularly for cannabis-related problems. Additionally, exploratory analyses revealed statistically significant (cross-sectional) indirect effects of distress tolerance on substance-related problems via substance-use motivations related to neutralizing negative emotions. CONCLUSIONS Distress tolerance's role in substance-use problems appears to generalize beyond North America, although effect sizes were generally small and varied notably across geographical regions. Distress tolerance's connection with negative reinforcement processes (e.g., coping motives) warrants attention as a possible mediator of its association with problematic substance use.
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Affiliation(s)
- Grace N Anderson
- Department of Psychology, Fordham University, Bronx, New York, USA
| | | | - Adrian J Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, USA
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Buckner JD, Vargo LA, Zvolensky MJ. Understanding the role of cannabis use on cigarette dependence severity among individuals with e-cigarette and combustible tobacco dual use. Am J Addict 2024. [PMID: 38992890 DOI: 10.1111/ajad.13633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 06/04/2024] [Accepted: 07/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The use of both electronic and combustible cigarettes is related to greater rates of cannabis use. Further, cannabis use is associated with worse combustible smoking-related outcomes, yet little research has identified mechanisms underlying such relations. It may be that negative-affect-related transdiagnostic factors such as emotion dysregulation, anxiety sensitivity, and/or distress intolerance play a mechanistic role in the cannabis-tobacco interrelations. METHODS The current study tested this hypothesis among 400 adults who endorsed dual use, 33% of whom endorsed current (past 3 months) cannabis use. We conducted analyses of variance and indirect effects model using the PROCESS v4.1 macro in SPSS version 29. RESULTS Results indicated that participants who use cannabis reported greater difficulty with emotion regulation, anxiety sensitivity, and cigarette dependence severity. Cannabis use was related to cigarette dependence severity indirectly via difficulty with emotion regulation and anxiety sensitivity. DISCUSSION AND CONCLUSIONS These results indicate that specific transdiagnostic negative-affect-related factors of difficulty with emotion regulation and anxiety sensitivity are associated with cannabis use among adults who smoke combustible and electronic cigarettes. SCIENTIFIC SIGNIFICANCE Given that these transdiagnostic factors are malleable, these findings suggest targeting and engaging such mechanisms may offer novel behavioral change strategies for this high-risk population.
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Affiliation(s)
- Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Luke A Vargo
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
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Bernusky HCR, Tibbo PG, Conrod PJ, Yunus FM, Keough MT, Thompson KD, Krank MD, Hadwin AF, Stewart SH. Do anxiety symptoms and coping motives serially mediate the association between psychotic-like experiences and cannabis-related problems in undergraduate recent cannabis users? Addict Behav 2024; 151:107937. [PMID: 38113687 DOI: 10.1016/j.addbeh.2023.107937] [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: 05/20/2023] [Revised: 11/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023]
Abstract
Many Canadian emerging adults (ages 18-25 years) use cannabis, with 60 % of past-three-month users experiencing one or more cannabis-related problems (i.e., adverse consequences of use). While psychotic-like experiences (PLEs) and cannabis problems overlap, little is known about the mechanisms explaining this link. One hypothesis is that PLEs are distressing and give rise to anxiety, with which emerging adults attempt to cope through increased cannabis use, in turn increasing their risk for cannabis-related problems. We tested a chained-mediational model to determine if anxiety and coping-with-anxiety motives for cannabis use sequentially mediated the link between PLEs and cannabis problems in emerging adult undergraduates; a conditional process model tested for moderation by sex. Emerging adult cannabis users (N = 413; mean [SD] age = 19.1 [1.5] years; 71.9 % female) from five Canadian universities provided cross-sectional, self-report survey data in fall 2021. Validated measures of PLEs, anxiety, cannabis coping-with-anxiety motives, and cannabis-related problems were administered. Path analyses supported the hypothesized chained mediational indirect effect (b = 0.027, 95 % bootstrap CI [0.012, 0.050]). No direct effect was found (p =.698), suggesting that the PLEs-to-cannabis problems association is fully explained by anxiety and cannabis coping-with-anxiety motives. Inconsistent with hypotheses, mediation did not depend on sex (95 % CIs crossed zero); therefore, anxiety and cannabis coping-with-anxiety motives explain the link between PLEs and cannabis problems in emerging adults regardless of their sex. Results highlight anxiety and cannabis coping-with-anxiety motives as potentially important intervention targets in cannabis-using emerging adults with PLEs, possibly preventing the development/worsening of cannabis-related problems.
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Affiliation(s)
- Haley C R Bernusky
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada
| | - Patricia J Conrod
- Département de psychiatrie et d'addictologie, Université de Montréal, 2900, boulevard Édouard-Montpetit, bureau S-750, Pavillon Roger-Gaudry, Montréal, Québec H3T 1J4, Canada
| | - Fakir M Yunus
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada
| | - Matthew T Keough
- Department of Psychology, York University, 4700 Keele Street, 225 Behavioural Science Building, North York, Ontario M3J 1P3, Canada
| | - Kara D Thompson
- Department of Psychology, St. Francis Xavier University, 2323 Notre Dame Avenue, 125 Annex, Antigonish, Nova Scotia B2G 2W5, Canada
| | - Marvin D Krank
- Department of Psychology, University of British Columbia, 1147 Research Road, ART 334, Kelowna, British Columbia V1V 1V7, Canada
| | - Allyson F Hadwin
- Department of Educational Psychology and Leadership Studies, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada
| | - Sherry H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, Nova Scotia B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Life Sciences Centre (Psychology Wing), Halifax, Nova Scotia B3H 4R2, Canada.
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Morris PE, Vargo LA, Buckner JD. Social Anxiety and Cannabis-Related Problems: The Serial Roles of Distress Tolerance and Cannabis Use Motives. Subst Use Misuse 2024; 59:1133-1140. [PMID: 38403969 PMCID: PMC11025634 DOI: 10.1080/10826084.2024.2320400] [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] [Indexed: 02/27/2024]
Abstract
Background: Individuals with elevated social anxiety are vulnerable to experiencing negative consequences related to cannabis use. One transdiagnostic vulnerability factor that has received little attention in the social anxiety-cannabis problem relation is distress tolerance, which is associated with more cannabis use to manage negative affect broadly (i.e., coping motives) and cannabis-related problems. However, it is unknown whether distress tolerance is related to greater cannabis use to manage social anxiety specifically (i.e., social anxiety motives). Objectives: This study tested whether the relation between social anxiety and cannabis problems occurred via perceived distress tolerance among 309 (77.3% female) undergraduates who endorsed current (past three-month) cannabis use. Results: Social anxiety was negatively associated with distress tolerance and positively associated with cannabis problems, coping, and social anxiety motives. Social anxiety was indirectly (via distress tolerance) related to more cannabis problems and motives to cope with negative affect generally and to cope with social anxiety specifically. Social anxiety was indirectly related to more cannabis problems via the serial effects of distress tolerance and coping and social anxiety motives. Conclusions: Findings suggest that individuals with elevated social anxiety may be vulnerable to using cannabis to manage negative affect (generally and social anxiety specifically) due to low perceived ability to tolerate psychological distress, which may lead to more cannabis problems. Keywords: cannabis; marijuana; distress tolerance; social anxiety; motives; coping motives.
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Affiliation(s)
- Paige E. Morris
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Luke A. Vargo
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
| | - Julia D. Buckner
- Louisiana State University, Department of Psychology, 236 Audubon Hall, Baton Rouge, LA 70803, USA
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Najera MS, Cavalli JM, Cservenka A. Distress tolerance and problematic cannabis use: does the form of cannabis matter? J Addict Dis 2023:1-11. [PMID: 37565482 DOI: 10.1080/10550887.2023.2244378] [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: 08/12/2023]
Abstract
BACKGROUND Low distress tolerance may result in greater vulnerability to problematic cannabis use. However, the role of the primary form of cannabis used has not been examined as a moderator of this association. While marijuana flower remains the preferred form of cannabis, the popularity of other forms of cannabis, including concentrates and edibles, is on the rise. OBJECTIVES We examined the association between distress tolerance and problematic cannabis use and whether the primary form of cannabis used moderates this relationship. METHODS Participants were 695 (67.6% male) past-month cannabis users who completed an online survey. Multiple linear regressions assessed whether distress tolerance, the primary form of cannabis used, and their interaction were related to problematic cannabis use while controlling for demographic variables and past 30-day alcohol and cannabis use frequency. RESULTS Lower tolerance for distress was associated with more problematic cannabis use. Endorsing concentrates as the primary form of cannabis used vs. marijuana flower was related to more problematic cannabis use while reporting edibles as the primary form of cannabis used vs. marijuana flower or concentrates was related to less problematic cannabis use. Individuals preferring marijuana flower or concentrates reported more problematic cannabis use at lower levels of distress tolerance. CONCLUSIONS Cannabis users exhibiting low distress tolerance or a preference for concentrates may be at greatest risk for experiencing negative consequences related to their cannabis use. Additionally, building tolerance for stressful situations, among both concentrates and marijuana flower users, may aid in minimizing problematic cannabis use.
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Affiliation(s)
- Melissa S Najera
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Jessica M Cavalli
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
| | - Anita Cservenka
- School of Psychological Science, Oregon State University, Corvallis, OR, USA
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Giberson ER, Olthuis JV, Connell EM. Investigating the Relation between Anxiety Sensitivity and Substance Use: What Are the Roles of Social Anxiety and Outcome Expectancies? Subst Use Misuse 2023; 58:1634-1642. [PMID: 37466359 DOI: 10.1080/10826084.2023.2236221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Objective: Research on the association between anxiety sensitivity (AS) and substance use is mixed, with some studies showing a positive association and others showing no association. Other relevant variables, such as social anxiety and outcome expectancies, may help us understand how and for whom AS is linked to substance use. This study tested (a) the associations between AS and alcohol use, cannabis use, and drinking games and pregaming behaviors among young adults, and (b) the mediating role of social anxiety and moderating role of outcome expectancies in these associations. Method: Participants (N = 199, 69% women) were young adults (19 to 25 years) who completed a 30-minute online self-report questionnaire on their substance use. Results: Results revealed significant negative associations between AS and drinking game and pregaming participation. AS was not directly associated with other substance use outcomes. The association between AS and hazardous cannabis use was moderated by relaxation and tension reduction expectancies, but outcome expectancies did not moderate any of the other associations between AS and substance use outcomes. Social anxiety mediated the associations between AS and hazardous cannabis use and both drinking game and pregaming participation. Conclusions: Findings highlight the complex association between AS and different substance use outcomes. Outcome expectancies and social anxiety may help explain how AS is associated with hazardous cannabis use and drinking game/pregaming participation, respectively. More effective interventions can be developed by understanding the relation between AS and substance use.
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Affiliation(s)
- Emma R Giberson
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, USA
| | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, USA
| | - Emma M Connell
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, USA
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Wesner E, Pavuluri A, Norwood E, Schmidt B, Bernat E. Evaluating competing models of distress tolerance via structural equation modeling. J Psychiatr Res 2023; 162:95-102. [PMID: 37121119 DOI: 10.1016/j.jpsychires.2023.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/13/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
Distress Tolerance (DT) is a transdiagnostic risk and maintenance factor implicated in a wide range of internalizing spectrum (INT) disorders. DT is commonly conceptualized as a higher-order construct, yet its lower-order dimensions are still debated. While the tolerance of negative emotions, frustration, and physical discomfort are widely considered to be central features of DT, the inclusions of intolerance of uncertainty (IU) and anxiety sensitivity (AS) are disputed. This study is the first to compare the two leading hierarchical models of DT directly. We also propose and test a DT model which includes IU and AS as lower-order dimensions. This "combined" model drew from the prior hierarchical theories and subsequent research demonstrating IU and AS to be highly correlated. To evaluate the competing models of DT, structured equation modeling was used to construct latent models representing each leading model and our novel "combined" model. A clinical sample was analyzed (N = 278), with participants having completed self-report scales measuring DT's theorized lower-order dimensions. Of the proposed models, the "combined" model demonstrated the best fit indices in the context of INT. A regression model with our "combined" model indicated that even after its shared variance with the Distress Intolerance Index (DII) was removed, it still had a moderate association with INT (β = 0.805, p < .01). This suggests that the only extant measure of the higher-order DT construct, the DII, fails to capture considerable variance in its latent structure. Future directions are discussed.
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Wolitzky-Taylor K, Smit T, Vujanovic AA, Zvolensky MJ. Transdiagnostic Processes Linking Posttraumatic Stress Disorder Symptoms to Alcohol Use Severity. J Dual Diagn 2023; 19:97-110. [PMID: 37389859 DOI: 10.1080/15504263.2023.2225373] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Objective: The high comorbidity between posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is well-established and complex. However, there is a need to explore transdiagnostic constructs that may underlie this association to better understand what accounts for this comorbidity and to inform treatment development. Method: Thus, the present study utilized a large, cross-sectional dataset (N = 513; Mage = 38.25 years, SD = 10.07; 49.9% female), based on national recruitment, to (1) examine whether the associations between PTSD symptom severity (PCL-5) and alcohol use severity (AUDIT) were statistically mediated by (a) anxiety sensitivity (SSASI); and (b) difficulties with emotion regulation (DERS-16); and (2) examine whether coping motives for drinking moderate this indirect effect. Sex assigned at birth was included as a covariate. Results: When examining the hypothesized mediators (SSASI and DERS-16) in separate models, there was a statistically significant indirect effect of PCL-5 on AUDIT through both SSASI and DERS. However, when both SSASI and DERS were entered into a model simultaneously, only SSASI served as a statistically significant mediator. Coping motives for drinking did not moderate the observed indirect effect. Conclusions: The current findings highlight anxiety sensitivity and emotion regulation as transdiagnostic processes that may explain, at least partially, the relationship between PTSD symptom severity and alcohol use; however, stronger evidence was evident for anxiety sensitivity. These findings may help inform the development of refined, streamlined interventions for PTSD and alcohol use that directly target these processes.
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Affiliation(s)
- Kate Wolitzky-Taylor
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California - Los Angeles, Los Angeles, California, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Geyer RB, Magee JC, Clerkin EM. Anxiety sensitivity and panic symptoms: the moderating influence of distress tolerance. ANXIETY, STRESS, & COPING 2022:1-18. [DOI: 10.1080/10615806.2022.2146102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Elise M. Clerkin
- Student Health and Wellness, University of Virginia, Charlottesville, VA, USA
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Distress tolerance and reactivity to negative affective cues in naturalistic environments of cannabis-using emerging adults. Drug Alcohol Depend 2022; 238:109588. [PMID: 35932750 PMCID: PMC9875670 DOI: 10.1016/j.drugalcdep.2022.109588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Distress tolerance (DT) has been implicated as an important factor in the experience of negative affect (NA) and cannabis craving. However, previous research is limited by its use of laboratory paradigms that may not replicate in naturalistic settings. The current study examined how DT influenced reactivity to NA cues in daily life in a sample of frequent (≥3 times per week) cannabis-using emerging adults (age 18-21). METHODS Using cue-reactivity ecological momentary assessment (CREMA), 63 (54 % female; 85.7 % white; Mage = 19.62) participants reported on their cannabis craving and affect (sadness, relaxation) four semi-random times per day for two weeks (56 possible CREMA sessions/participant). We assessed affect and cannabis craving before and after exposure to neutral and NA cues. Multilevel modeling was used to examine within- and between-participant effects of cues, DT, and sex, as well as within- and between-participant average pre-cue affect and craving, on post-cue affect and craving. RESULTS NA cues consistently predicted higher-than-normal post-cue sadness and lower relaxation, but not greater-than-normal post-cue craving. Cue type interacted with sex and DT to predict post-cue sadness, but not craving. Female participants and those reporting low DT reported higher sadness following NA cues compared to males and those with high DT, respectively. CONCLUSIONS Frequent cannabis-using emerging adults differed in affect, but not cannabis craving, reactivity to NA cues as a function of sex and DT. Our results were partially consistent with prior human laboratory and CREMA research finding greater reactivity to NA cues among females and individuals with low DT.
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Ng JY, Chang N. A bibliometric analysis of the cannabis and cannabinoid research literature. J Cannabis Res 2022; 4:25. [PMID: 35610633 PMCID: PMC9131698 DOI: 10.1186/s42238-022-00133-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 04/12/2022] [Indexed: 11/12/2022] Open
Abstract
Background Cannabis refers to a plant in the family Cannabaceae, which has been used medically, recreationally, and industrially. The last two decades, in particular, have seen a large increase in the volume of literature on this topic. The present bibliometric analysis aims to capture the characteristics of scholarly journal publications on the topic of cannabis and cannabinoid research. Methods Searches were run on the Scopus database on April 02, 2021, as follows “(TITLE (cannabi* OR hashish OR marijuana OR marihuana)) AND ( LIMIT-TO ( DOCTYPE,"ar" ) OR LIMIT-TO ( DOCTYPE,"re" ) )”. Results were exported on the same day to prevent discrepancies between daily database updates. Only “article” and “review” publication types were included; no further search limits were applied. The “article” publication type includes publications featuring original research, whereas “review” includes reviews and conference papers. The following data were collected: number of publications (in total and per year), authors, and journals; open access status; publications per journal; journals publishing the highest volume of literature and their impact factors, language of publication; document type; publication country; author affiliations; funding sponsors; most highly cited publications; and most highly published authors. Trends in this subset of publications were identified and presented. Bibliometric networks were constructed using the software tool VOSviewer. Results A total of 29 802 publications (10 214 open access), published by 65 109 authors, were published in 5474 journals from 1829 to 2021. The greatest number of publications was published over the last 20 years. The journal that published the largest number of publications was Drug and Alcohol Dependence (n = 705). The most productive countries included the USA (n = 12 420), the UK (n = 2236), and Canada (n = 2062); many of the most common institutional affiliations and funding sponsors originated from these countries. Conclusions The number of publications published on the topic of cannabis follows an upward trend. Over the past 20 years, the volume of cannabis research has grown steeply, which can be attributed to a large amount of funding dedicated to researching this topic. Future research should continue to investigate changes in the publication characteristics of emerging research, as the volume of publications on this topic is expected to rapidly grow. Supplementary Information The online version contains supplementary material available at 10.1186/s42238-022-00133-0.
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Affiliation(s)
- Jeremy Y Ng
- Michael G. DeGroote Centre for Learning and Discovery, Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada.
| | - Nathan Chang
- Michael G. DeGroote Centre for Learning and Discovery, Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Room 2112, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada
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Larrazabal MA, Naragon-Gainey K, Conway CC. Distress Tolerance and Stress-induced Emotion Regulation Behavior. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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15
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Short NA, Evans MK, Raudales AM, Shapiro M, Weiss NH, Schmidt NB. Anxiety sensitivity and cannabis use motives among trauma-exposed young adult cannabis users. Am J Addict 2022; 31:242-250. [PMID: 35365953 PMCID: PMC9117414 DOI: 10.1111/ajad.13285] [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: 03/11/2021] [Revised: 01/18/2022] [Accepted: 03/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Anxiety sensitivity, or fear of anxious arousal, may be an important risk factor for problematic cannabis use. Specifically, anxiety sensitivity may motivate cannabis use to cope with distress, particularly among trauma-exposed individuals. The current study tested associations among anxiety sensitivity, its subdomains, and cannabis use motives in a sample of trauma-exposed cannabis users. We hypothesized elevated anxiety sensitivity, particularly cognitive concerns, would be associated with increased maladaptive coping use motives, after covarying for the number of traumas and cannabis use quantity. METHOD Hypotheses were tested in a cross-sectional study of trauma-exposed young adult cannabis users (N = 56) (Mage = 20.7 years, 59% women, 73% white). Participants completed self-report measures, and a clinical interview assessing cannabis use quantity. RESULTS Multiple regression analyses indicated that elevated anxiety sensitivity was associated with increased cannabis use coping motives, after covarying for the number of traumas experienced and cannabis use quantity. Specifically, higher levels of anxiety sensitivity cognitive and social concerns were associated with coping motives for cannabis use. DISCUSSION AND CONCLUSIONS Anxiety sensitivity, particularly concerns about cognitive dyscontrol and negative social evaluations of anxious arousal, may motivate cannabis use to cope with stress among trauma-exposed cannabis users. Future research should include prospective studies with diverse samples to replicate results and determine whether intervening on anxiety sensitivity could reduce maladaptive coping motives for cannabis use. SCIENTIFIC SIGNIFICANCE The current study replicates prior research indicating anxiety sensitivity, particularly cognitive concerns, is associated with maladaptive cannabis use. Expanding on prior research, findings indicated anxiety sensitivity is associated with coping motives for cannabis use among trauma-exposed cannabis users.
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Affiliation(s)
- Nicole A. Short
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | - Mariah K. Evans
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Alexa M. Raudales
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Mary Shapiro
- Southeastern Louisiana VA Health Care System, New Orleans, LA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Hartmann SA, McLeish AC. Tolerance for specific negative affective states and coping-oriented cannabis use motives among college student cannabis users. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:911-917. [PMID: 32673174 DOI: 10.1080/07448481.2020.1781135] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/11/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
ObjectiveThe current study examined the unique predictive ability of tolerance of specific negative affective states in relation to frequency of past-month cannabis use and coping-oriented cannabis use motives. Participants: 416 undergraduates who reported past 30 day cannabis use (65.1% female; Mage = 19.46, SD = 2.56). Methods: Participants completed self-report questionnaires for course credit. Results: After accounting for the effects of sex, negative affectivity, and tolerance of other specific negative affective states, lower levels of tolerance for sadness, but not any other negative affective states, significantly predicted more frequent cannabis use in the past 30 days (1.1% unique variance) and coping motives (1.1% unique variance). Conclusions: These findings suggest that cannabis users who have difficulty withstanding sad mood states use cannabis more frequently and are motivated to use cannabis to cope with this specific mood state and not necessarily negative affective states more broadly.
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Affiliation(s)
- Sarah A Hartmann
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
| | - Alison C McLeish
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, USA
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17
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Mattingley S, Youssef GJ, Manning V, Graeme L, Hall K. Distress tolerance across substance use, eating, and borderline personality disorders: A meta-analysis. J Affect Disord 2022; 300:492-504. [PMID: 34986376 DOI: 10.1016/j.jad.2021.12.126] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/08/2021] [Accepted: 12/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Distress tolerance (DT) has received increased attention in recent years due to its purported role in dysregulated behaviours and their clinical manifestations, such as problematic substance use (PSU), disordered eating behaviours (e.g., binge-eating and purging; DEB), and borderline personality disorder (BPD) symptomatology. Despite the proposed transdiagnostic utility of DT across PSU, DEB, and BPD, there has yet to be a systematic and comprehensive examination characterising and comparing its association with this class of impulsive-type psychopathology. METHODS A systematic search was conducted across five electronic databases using search terms designed to capture extant literature on the association between DT and PSU, DEB, and BPD symptomatology. A series of meta-analyses were undertaken on correlation coefficients from 81 studies to examine the association between DT and each psychopathology domain, as well as impulsive-type psychopathology overall. Moderator analyses were conducted to examine whether these relationships were moderated by DT measurement type, sample type, age, and gender. RESULTS DT shared significant, negative, medium correlations with PSU (r = -.18,), DEB (r = -.20), and BPD symptomatology (r = -.27). The magnitude of these associations was not significantly different across the three psychopathology domains, supporting transdiagnostic conceptualisation. DT measurement type, age, and sample type moderated several of these indicated relationships. LIMITATIONS The majority of studies were conducted in adult samples from Western countries, limiting understanding of these relationships across development and different cultures. CONCLUSIONS The present findings support the putative transdiagnostic role of DT across PSU, DEB, and BPD, which may ultimately inform novel, cross-cutting interventions.
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Affiliation(s)
| | - George J Youssef
- Deakin University, Geelong, Australia, School of Psychology; Centre for Drug Use, Addictive, and Anti-social Behaviour Research (CEDAAR), Deakin University, Australia; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Victoria Manning
- Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Monash University, Australia; Turning Point, Eastern Health, Australia
| | - Liam Graeme
- Deakin University, Geelong, Australia, School of Psychology
| | - Kate Hall
- Deakin University, Geelong, Australia, School of Psychology; Centre for Drug Use, Addictive, and Anti-social Behaviour Research (CEDAAR), Deakin University, Australia.
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Cannabis Use among Black Young Adults: The Interactive Effects of Ethnic-Racial Identity, Anxiety, and Sex. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10296-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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19
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Targeting maladaptive reactivity to negative affect in emerging adults with cannabis use disorder: A preliminary test and proof of concept. Behav Res Ther 2022; 150:104032. [DOI: 10.1016/j.brat.2022.104032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/27/2021] [Accepted: 01/05/2022] [Indexed: 11/22/2022]
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Votaw VR, Witkiewitz K. Motives for Substance Use in Daily Life: A Systematic Review of Studies Using Ecological Momentary Assessment. Clin Psychol Sci 2021; 9:535-562. [PMID: 34447615 DOI: 10.1177/2167702620978614] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The motivational model of substance use posits four motive subtypes (coping, enhancement, social, conformity) dynamically interact with contextual factors to impact decisions about substance use. Yet, prior studies assessing the motivational model have relied on between-person, cross-sectional evaluations of trait motives. We systematically reviewed ecological momentary assessments (EMA) studies (N=64) on motives for substance use to examine: methodological features of EMA studies examining the motivational model, support for the motivational model between and within individuals, and associations between trait motives and daily processes. Results of the reviewed studies provide equivocal support for the motivational model, and suggest that EMA measures and trait measures of motives might not reflect the same construct. The reviewed body of research indicates most studies have not examined the momentary and dynamic nature of the motivational model and more research is needed to inform interventions that address heterogeneous reasons for substance use in daily life.
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Affiliation(s)
- Victoria R Votaw
- Department of Psychology, Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico
| | - Katie Witkiewitz
- Department of Psychology, Center on Alcoholism, Substance Abuse, & Addictions, University of New Mexico
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Raines AM, Ennis CR, Allan NP, McGrew SJ, Walton JL, Rogers AH, Zvolensky MJ, Schmidt NB, Laurel Franklin C. Anxiety sensitivity and substance use: Differential levels across individuals primarily using opioids, cannabis, or stimulants. Addict Behav 2021; 116:106791. [PMID: 33497865 DOI: 10.1016/j.addbeh.2020.106791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of the current study was to compare levels of anxiety sensitivity (AS) across a treatment-seeking sample of individuals primarily using opioids, stimulants, or cannabis. Consistent with the idea that individuals high in AS may be motivated to use substances with real or perceived anxiolytic properties, it was hypothesized that individuals primarily using opioids or cannabis would evidence higher levels of AS compared to individuals primarily using stimulants. METHODS The sample consisted of 110 veterans (including 29 individuals primarily using opioids, 42 primarily using cannabis, and 39 primarily using stimulants) presenting for psychological services to a Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) specialty clinic at a large southeastern Veteran Affairs (VA) hospital. RESULTS AS levels varied by group with individuals primarily using stimulants evidencing the highest levels followed by those primarily using opioids and then those primarily using cannabis. Individuals primarily using stimulants had statistically significantly higher levels of AS physical concerns compared to individuals primarily using cannabis but not those primarily using opioids. Further, individuals who primarily use opioids did not differ from those primarily using cannabis. CONCLUSIONS Taken together, these findings call into question the notion that AS may be negatively related to the use of substances that have anxiogenic properties.
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22
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Davis JP, Christie NC, Pakdaman S, Hummer J, DeLeon J, Clapp J, Pedersen ER. Multifaceted impulsivity as a moderator of social anxiety and cannabis use during pregaming. J Anxiety Disord 2020; 76:102320. [PMID: 33011556 PMCID: PMC7814868 DOI: 10.1016/j.janxdis.2020.102320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/10/2020] [Accepted: 09/21/2020] [Indexed: 01/11/2023]
Abstract
Individuals may drink or use cannabis to cope with social anxiety, and drinking or using cannabis prior to social situations (e.g., pregaming) may be a way to limit the experience of anxiety when entering social settings. However, theoretical and empirical work has reported mixed associations between social anxiety and substance use, specifically alcohol and cannabis. Little work has looked at how other variables, such as impulsivity (a central component to high risk drinking such as pregaming), may shed light onto these mixed findings. College students who reported past year pregaming (n = 363) completed self-report surveys. Supporting prior work, we found that social anxiety was associated with fewer pregaming days, even among those high in sensation seeking. However, those reporting higher social anxiety also reported higher cannabis use during pregaming, specifically among those who reported high sensation seeking and high positive urgency. Results suggest specific facets of impulsivity may affect the association between social anxiety and cannabis use during high risk drinking events.
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Affiliation(s)
- Jordan P. Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, Los Angeles CA. USC Center for Artificial Intelligence in Society; USC Center for Mindfulness Science; USC Institute for Addiction Science
| | - Nina C. Christie
- University of Southern California, Department of Psychology; USC Institute for Addiction Science
| | - Sheila Pakdaman
- University of Southern California, Department of Preventive Medicine and Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science
| | - Justin Hummer
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407
| | - Jessenia DeLeon
- University of Southern California, Department of Preventive Medicine and Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science
| | - John Clapp
- University of Southern California, Department of Preventive Medicine and Suzanne Dworak-Peck School of Social Work; USC Institute for Addiction Science
| | - Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street, Suite 2200, Los Angeles, CA 90033
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23
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Distress tolerance in methamphetamine and opium abusers with non-drug abuser (A comparative analysis). CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2019.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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25
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Bilsky SA, Cloutier RM, Guillot CR, Bynion TM, Lewis SF. Relations Between Parental Distress Intolerance, Adolescent Motives for Cigarette Use, and Adolescent Cigarette Smoking Levels. Subst Use Misuse 2019; 54:2207-2217. [PMID: 31299868 PMCID: PMC6849207 DOI: 10.1080/10826084.2019.1638937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: A relatively large body of evidence indicates that coping motives for cigarette smoking are associated with a number of problematic outcomes (e.g., greater smoking frequency) among adolescents. Evidence also indicates that lower distress tolerance (or higher distress intolerance) is related to higher levels of coping motives for cigarette smoking among adults and adolescents. Therefore, it is critical to improve our understanding of factors that may increase the likelihood of smoking to cope among adolescents. In addition, evidence suggests that a number of parenting behaviors may affect adolescent smoking behavior. No work to date, however, has examined the relation between parental distress intolerance and adolescent smoking motives, or adolescent smoking behavior. Objective/methods: The current study involving adolescents (n = 46) and one of their parents aimed to address this gap in the literature by examining the association between parent-reported parental distress intolerance, self-reported adolescent motives for cigarette use, and self-reported adolescent cigarette smoking levels. Results: Results indicated that parental distress intolerance was related to greater adolescent coping motives for cigarette smoking, but not to other motives for adolescent cigarette use. Furthermore, results indicated that parental distress intolerance was indirectly associated with higher adolescent cigarette smoking levels through adolescent coping motives for cigarette smoking. Conclusions: Parental distress intolerance is associated with coping motives for adolescent cigarette smoking. This suggests parental emotional factors may be associated with adolescent cigarette use.
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Affiliation(s)
- Sarah A. Bilsky
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Renee M. Cloutier
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Casey R. Guillot
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Teah M. Bynion
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, USA
| | - Sarah F. Lewis
- Center for Research, Assessment, and Treatment Efficacy (CReATE), Asheville, NC, USA
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26
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Manning K, Garey L, Paulus DJ, Buckner JD, Hogan JB, Schmidt NB, Zvolensky MJ. Typology of cannabis use among adults: A latent class approach to risk and protective factors. Addict Behav 2019; 92:6-13. [PMID: 30553940 DOI: 10.1016/j.addbeh.2018.12.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cannabis is among the most widely used substances worldwide. The United States has seen an increase in the number of adult daily cannabis users and in the number of adults diagnosed with cannabis use disorder. However, little work has examined patterns of use or unique subgroups of adult cannabis users, which may be useful in developing targeted treatment interventions for problematic cannabis users. Therefore, the current study used latent profile analysis to identify whether cannabis users can be categorized across distinct subgroups of adult users. METHOD The sample included 374 current cannabis using adults (64.2% Male; Mage = 32.6). Cannabis use frequency, quantity, and related problems were used to differentiate subgroups. Further, age, race, emotion dysregulation, affect, anxiety sensitivity, other substance use, and motives for cannabis use were examined as class correlates. RESULTS Results supported five unique classes of cannabis users, generally ranging from light, infrequent users with few problems to heavy, frequent users with more problems. Additionally, race, negative affectivity, anxiety sensitivity, emotion regulation, cannabis use motives, and alcohol use emerged as unique predictors of class membership. The current findings substantiate past work for heterogeneous latent classes that underlie the larger cannabis using population, however, this study provides novel evidence for subgroups of adult users. CONCLUSION The identification of different classes of cannabis users may inform future treatment interventions, and ultimately, lead to the development of personalized treatments for each class based on correlates of group membership.
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27
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Reese ED, Conway CC, Anand D, Bauer DJ, Daughters SB. Distress tolerance trajectories following substance use treatment. J Consult Clin Psychol 2019; 87:645-656. [PMID: 31008636 DOI: 10.1037/ccp0000403] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Distress tolerance (DT), the ability to withstand aversive internal states, represents an important risk factor for substance use relapse and a potential treatment target. Neurobiological research in substance using populations suggests that continued substance use could erode DT, whereas abstinence could bolster it. The current study characterized trajectories of behavioral and self-reported indices of DT and examined the prospective effect of substance use on DT trajectories among those seeking treatment for substance use. METHOD Individuals (N = 263, Mage = 42.68, SD = 11.8, 70.7% male, 94.7% African American) in residential substance use treatment completed subjective (Distress Tolerance Scale) and behavioral (Mirror Tracing Persistence Task-computerized version) DT measures, as well as report of daily substance use (timeline follow-back) over 5 assessment time-points from pretreatment to 12 months posttreatment. Latent curve modeling estimated DT trajectories and their associations with substance use behavior, including abstinence duration (days until first use) and substance use frequency (percentage of substance use days between assessments). RESULTS Self-reported and behavioral DT indicators both exhibited positive, nonlinear change over time (standardized slope parameter estimates: Distress Tolerance Scale β = 0.61, p < .01; Mirror Tracing Persistence Task β = 0.34, p < .01). Abstinence duration was associated with greater improvement in behavioral (β = .20, p = .03) DT specifically. Frequency of use was statistically significantly associated with attenuated behavioral DT at 6-month (β = -.12, p = .03) and 12-month follow-ups (β = -.08, p = .045). CONCLUSIONS DT appears to improve appreciably posttreatment, and return to substance use may shape the degree of this improvement. Collectively, these findings support the conceptualization of DT as a malleable treatment target and emphasize the benefit of abstinence on improvement in DT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Elizabeth D Reese
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | | | - Deepika Anand
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Daniel J Bauer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Stacey B Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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28
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Paltell KC, Bing-Canar H, Ranney RM, Tran JK, Berenz EC, Vujanovic AA. Anxiety Sensitivity Moderates the Effect of Posttraumatic Stress Disorder Symptoms on Emotion Dysregulation among Trauma-Exposed Firefighters. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2019. [DOI: 10.1007/s10862-019-09731-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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29
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Peraza N, Smit T, Garey L, Manning K, Buckner JD, Zvolensky MJ. Distress tolerance and cessation-related cannabis processes: The role of cannabis use coping motives. Addict Behav 2019; 90:164-170. [PMID: 30408699 DOI: 10.1016/j.addbeh.2018.10.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 10/30/2018] [Accepted: 10/30/2018] [Indexed: 02/07/2023]
Abstract
Robust evidence implicates perceived distress tolerance as a risk factor for maladaptive cannabis use and poorer cannabis cessation outcomes. Past work suggests that perceived distress tolerance may be related to an array of clinically-relevant cannabis processes and outcomes via cannabis coping motives. Although promising, the generalizability of this work to racially/ethnically diverse samples of adult cannabis users is unknown. Additionally, investigation into alternative cannabis processes has been limited and has not controlled for the effects of other cannabis motives. Thus, the present study investigated cannabis coping motives as an explanatory variable for the relation between perceived distress tolerance and cannabis use processes that may impede cessation (e.g., cannabis use cravings, perceived barriers to cannabis cessation, and withdrawal symptoms) among an ethnically diverse sample of current cannabis using adults. Participants included 131 adult cannabis users (Mage = 36.67 years; 29.8% female; 59.2% Black, 26.2% White, 16.0% Hispanic). Results indicated that perceived distress tolerance was indirectly associated with all criterion variables through cannabis coping motives after controlling for the variance attributable to four other motives. The current study builds upon previous theoretically-supported work by examining these models among an ethnically diverse sample of current cannabis using adults and testing alternative cessation-related cannabis processes while controlling for the independent effects of four other cannabis motives.
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30
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Stewart KL, Farris SG, Jackson KM, Borsari B, Metrik J. Cannabis Use and Anxiety Sensitivity in Relation to Physical Health and Functioning in post-9/11 Veterans. COGNITIVE THERAPY AND RESEARCH 2019; 43:45-54. [PMID: 33583981 DOI: 10.1007/s10608-018-9950-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Frequency of cannabis use and cognitive vulnerabilities such as anxiety sensitivity (i.e., the fear of bodily sensations), have been independently linked with poor physical health, however the interplay between these health-mental health processes may compound poor physical health and functioning in cannabis users. Thus, the current study evaluated the direct and interactive effects of cannabis use frequency and anxiety sensitivity on physical health and functioning among cannabis-using veterans. Participants (N = 138) were post-9/11 United States veterans recruited from a Veterans Affairs hospital who reported cannabis use in the past six months. Cannabis use frequency in the past month and anxiety sensitivity were significantly negatively correlated with perceived overall physical health. There was a significant interaction between cannabis use frequency and anxiety sensitivity, such that more frequent cannabis use was associated with poorer overall health and role functioning due to health problems among veterans with higher anxiety sensitivity (but not lower). Findings suggest that anxiety sensitivity is a cognitive vulnerability linked to poor perceived physical health and impairment among frequent cannabis users and could be targeted, along with cannabis use, for health-promotion in cannabis users.
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Affiliation(s)
- Kate L Stewart
- Providence VA Medical Center, Providence, RI, 02908, USA.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI
| | - Samantha G Farris
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI.,The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI 02903 USA.,Rutgers, the State University of New Jersey, Piscataway, NJ 08854 USA
| | - Kristina M Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA
| | - Brian Borsari
- San Francisco VA Health Care System, San Francisco, CA, 94121, USA.,Department of Psychiatry, University of California - San Francisco, San Francisco, CA, 94103, USA
| | - Jane Metrik
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, 02903, USA.,Providence VA Medical Center, Providence, RI, 02908, USA.,Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02912, USA
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Buckner JD, Walukevich Dienst K, Zvolensky MJ. Distress tolerance and cannabis craving: The impact of laboratory-induced distress. Exp Clin Psychopharmacol 2019; 27:38-44. [PMID: 30346191 PMCID: PMC6355373 DOI: 10.1037/pha0000231] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Low levels of distress tolerance have been identified as an important vulnerability factor for negative cannabis outcomes. The current study is the first known experimental manipulation of state distress to test whether distress tolerance interacts with state distress to predict the urge to use cannabis. Current cannabis users (N = 126; 88.9% with cannabis use disorder; 54.0% non-Hispanic Caucasian) were randomly assigned to a distress task condition or neutral (reading) task condition. Participants in the 2 conditions did not differ on distress tolerance, negative affect (NA), or craving at baseline. The distress tolerance × condition interaction significantly predicted task NA, such that low (but not high) distress tolerance was related to greater state NA throughout the task. The distress tolerance × condition interaction significantly predicted cannabis craving during the task, such that the distress condition was related to greater cannabis craving at lower (but not higher) levels of distress tolerance. In the distress condition, those who endorsed coping motives during the task reported lower distress tolerance. Together these findings suggest that individuals with lower distress tolerance experienced greater NA during a laboratory-induced distress and reported greater cannabis craving when NA was greatest during the task. This experimental study adds to a growing, but limited, literature implicating lower levels of distress tolerance to the maintenance and relapse of cannabis use. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Stein AT, Freeman SZ, Smits JAJ. Cognitive Mechanisms Underlying the Link Between Anxiety, Health Behaviors, and Illness Outcomes: Commentary on a Special Issue. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-09999-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cloutier RM, Kearns NT, Knapp AA, Contractor AA, Blumenthal H. Heterogeneous Patterns of Marijuana Use Motives Using Latent Profile Analysis. Subst Use Misuse 2019; 54:1485-1498. [PMID: 31017512 PMCID: PMC6833943 DOI: 10.1080/10826084.2019.1588325] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Given that marijuana use is often associated with detrimental physical and mental health problems, research examining motives for its use is critical for effective remedial and preventive treatment. To date, the majority of research on marijuana use motives has used variable-centered analyses, which overlooks potentially meaningful heterogeneous response patterns and the associations of those patterns with other risk/protective factors. Methods: To address this gap, in the current study, we conducted a person-centered analysis (latent profile analysis) to identify subgroups of participants based on endorsed marijuana use motives, and examined the construct validity of the optimal class solution (covariates included sociodemographic (e.g., age), psychiatric (e.g., depression), and marijuana-use indices (e.g., use-frequency, use-related problems). Participants were 898 college students (Mage = 20.93, SDage = 3.10; 68.9% female) who completed an anonymous online survey examining substance use and psychological well-being, were 18 years or older, and endorsed lifetime marijuana use. Data were collected November 2016 through February 2018. Results: Results identified four unique classes of coping, conformity, social, and enhancement marijuana use motives: (a) "Low Motives" (37.6%), (b) "High Conformity" (4.9%), (c) "Low Conformity" (45.8%), and (d) "High Motives" (11.7%). In terms of covariates, higher motive classes tended to report more frequent and problematic use. The two classes uniquely characterized by conformity motives only differed on past-month marijuana use frequency. Conclusions/Importance: The current findings provide evidence that specific classes of motives were not only associated with marijuana use frequency and problems but other risk and protective factors, such as anxiety sensitivity and social support.
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Affiliation(s)
- Renee M Cloutier
- a Department of Psychology , University of North Texas , Denton , Texas , USA
| | - Nathan T Kearns
- a Department of Psychology , University of North Texas , Denton , Texas , USA
| | - Ashley A Knapp
- b Department of Preventive Medicine, Center for Behavioral Intervention Technologies , Northwestern University , Chicago , Illinois , USA
| | - Ateka A Contractor
- a Department of Psychology , University of North Texas , Denton , Texas , USA
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Chen M. The research of human individual’s conformity behavior in emergency situations. LIBRARY HI TECH 2018. [DOI: 10.1108/lht-08-2018-0113] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper (including three studies) is to investigate the idea that individuals in an emergency situation experience significantly a higher level of emotional activation, lower performance of task, and change in decision making, escaping behavior and conformity as compared to being in a non-emergency situation. It is also suggested that the level of emotional activation mediates the association between situation and the performance of task.Design/methodology/approachStudy 1 was an experimental study with 43 university students and revealed that different situations induced different levels of emotional activation and they are positively and significantly related. Study 2 was a further exploration of study 1, in which 49 participants were asked to watch a recomposed video telling a reasonable story about escaping from the emergency and complete several tasks associated with two kinds of situations (non-emergency vs emergency). In study 3, 168 participants, randomly assigned to three groups, were asked to work on judgment tasks with different numbers of options.FindingsResults revealed that individuals in an emergency situation experience significantly lower performance of task and higher conformity tendency than in a non-emergency situation. Also, the causal effect of the situation on the performance of task is mediated by the level of emotional activation. Moreover, results found that the performance of task is also a mediator between the level of emotional activation and conformity. Result showed that the number of choices is negatively related to conformity, and performance is a mediator between the number of choices and conformity.Originality/valueThis paper suggested that the level of emotional activation mediates the association between situation and the performance of task.
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Oglesby ME, Short NA, Albanese BJ, Portero AK, Schmidt NB. Negative interpretations of distress-related information: A novel assessment tool for distress tolerance. J Anxiety Disord 2018; 60:20-25. [PMID: 30336368 DOI: 10.1016/j.janxdis.2018.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/25/2018] [Accepted: 10/09/2018] [Indexed: 11/30/2022]
Abstract
Distress tolerance (DT), defined as the perceived and/or actual behavioral capacity to tolerate negative emotional states, is considered an important risk factor for various externalizing and internalizing disorders. Despite the importance of DT in the development and maintenance of psychopathology, few reliable and valid indicators of DT have been developed. One potentially useful way to assess DT is through interpretation bias (IB) paradigms. The current study sought to examine the convergent validity, reliability, and clinical utility of a DT-focused IB paradigm by directly measuring an individual's interpretations of distressing information. Participants completed a DT-IB task and self-report questionnaires. Results found an association between DTS self-report and an exaggerated DT-IB. Reliability analyses found the word pairings in our DT-IB task to display good internal consistency. In addition, an exaggerated DT-IB was associated with diagnostic status after covarying for negative affect and self-report DTS and DT-IB was associated with increased levels of negative affect above and beyond self-report DTS. This study is the first to identify specific interpretation biases for distress-related information. Given the transdiagnostic nature of DT and the efficacy and accessibility associated with CBM-I protocols for related constructs, the present findings add considerably to a growing body of literature.
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Affiliation(s)
| | - N A Short
- Florida State University, United States
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Buckner JD, Zvolensky MJ, Ecker AH, Schmidt NB, Lewis EM, Paulus DJ, Lopez-Gamundi P, Crapanzano KA, Bakhshaie J. Integrated cognitive behavioral therapy for comorbid cannabis use and anxiety disorders: A pilot randomized controlled trial. Behav Res Ther 2018; 115:38-45. [PMID: 30442329 DOI: 10.1016/j.brat.2018.10.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 11/30/2022]
Abstract
Cannabis use disorder (CUD) is the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. The current study tested the acceptability and efficacy of the integration of a transdiagnostic anxiety CBT (i.e., treatment of patients with any anxiety disorder) with MET-CBT (integrated cannabis and anxiety reduction treatment, or ICART) for CUD compared to MET-CBT alone. Treatment-seeking cannabis users (56.4% male, Mage = 23.2, 63.3% non-Hispanic White) with CUD and at least one comorbid anxiety disorder were randomly assigned to ICART (n = 27) or MET-CBT (n = 28). Patients in the ICART condition attended significantly more treatment sessions than those in the MET-CBT condition. Patients in the ICART condition were more likely to be abstinent post-treatment than those in MET-CBT. Further, treatment produced decreases in cannabis use and related problems. Notably, therapy type did not moderate the impact of treatment on frequency of use and related problems. Together, these data suggest that ICART may be at least as efficacious as a gold-standard psychosocial CUD treatment, MET-CBT, for a difficult-to-treat subpopulation of cannabis users.
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Affiliation(s)
| | - Michael J Zvolensky
- University of Houston, Houston, TX, United States; University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Anthony H Ecker
- South Central Mental Illness Research Education and Clinical Center, Houston, TX, United States; Baylor College of Medicine, Houston, TX, United States
| | | | | | | | - Paula Lopez-Gamundi
- University of Texas Health Science Center at Houston, Houston, TX, United States
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Alsaid-Habia T, McLeish AC, Kraemer KM. Associations between distress tolerance and asthma symptoms and quality of life. J Asthma 2018; 56:1120-1127. [PMID: 30285494 DOI: 10.1080/02770903.2018.1520862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: Given the robust associations between anxiety and asthma, the purpose of the current study was to explore associations between asthma outcomes and tolerance for negative affective states (i.e. distress tolerance) as well as tolerance for the specific negative emotional states of anxiety and fear. Methods: Participants were 61 nonsmoking adults with asthma (61.9% female, 54.8% African-American, Mage = 34.72, SD = 13.58) who underwent spirometry and completed self-report measures. Results: After controlling for the effects of age, race and the physical concerns domain of anxiety sensitivity, poorer global distress tolerance and tolerance for fear and anxiety each significantly predicted poorer lung function (8.7-13.8% variance), asthma control (4.9-8.8% variance) and asthma-related quality of life (6.7-8.9%). Conclusions: These findings suggest that targeting distress tolerance, specifically tolerance of fear and anxiety, may be helpful in improving asthma outcomes.
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Affiliation(s)
| | - Alison C McLeish
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Kristen M Kraemer
- Division of General Medicine and Primary Care Section for Research, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
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Manning K, Rogers AH, Bakhshaie J, Hogan JBD, Buckner JD, Ditre JW, Zvolensky MJ. The association between perceived distress tolerance and cannabis use problems, cannabis withdrawal symptoms, and self-efficacy for quitting cannabis: The explanatory role of pain-related affective distress. Addict Behav 2018; 85:1-7. [PMID: 29787925 DOI: 10.1016/j.addbeh.2018.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/25/2023]
Abstract
Rates of cannabis use and related problems continue to rise, ranking as the third most common substance use disorder in the United States, behind tobacco and alcohol use. Past work suggests that perceived distress tolerance is related to several clinically significant features of cannabis use (e.g., coping-oriented use). However, there has been little exploration of the mechanisms that may underlie relations between perceived distress tolerance and cannabis use problems, withdrawal severity, and self-efficacy for quitting. The current study sought to examine the experience of pain, which frequently co-occurs with cannabis use (Ashrafioun, Bohnert, Jannausch, & Ilgen, 2015), as an underlying factor in the relation between perceived distress tolerance and cannabis related problems among 203 current cannabis-using adults (29.2% female, M = 37.7 years, SD = 10.2, 63% African American). Results indicated that perceived distress tolerance via pain related affective distress significantly predicted the severity of cannabis use problems (Pm = 0.60), degree of cannabis withdrawal (Pm = 0.39), and lower self-efficacy for quitting cannabis (Pm = 0.36). Future work may usefully explore the role of pain-related affective distress as a mechanistic factor in the context of perceived distress tolerance-cannabis relations.
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Affiliation(s)
- Kara Manning
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Andrew H Rogers
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Jafar Bakhshaie
- University of Houston, Department of Psychology, Houston, TX, United States
| | | | - Julia D Buckner
- Louisiana State University, Department of Psychology, Baton Rouge, LA, United States
| | - Joseph W Ditre
- Syracuse University, Department of Psychology, Syracuse, NY, United States
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
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Lee SY, Park CL, Russell BS. Does distress tolerance interact with trait anxiety to predict challenge or threat appraisals? PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Doan SN, Son H, Kim LN. Maternal and paternal emotional contributions to children's distress tolerance: Relations to child depressive symptoms. Psychiatry Res 2018; 267:215-220. [PMID: 29935480 DOI: 10.1016/j.psychres.2018.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 05/04/2018] [Accepted: 06/05/2018] [Indexed: 11/26/2022]
Abstract
In recent years, empirical studies have shown that the inability to tolerate distress is associated with a wide range of negative outcomes including eating addiction, drug abuse, alcohol use, and antisocial behavior in adults. However, few studies have examined family correlates of this ability in children. Also, past literature on child emotional competencies has mainly focused on documenting the linkages between mother and child and has neglected the role of fathers. Children (N = 54, M age = 10.15 years, SD = 1.02; 55.6% males) and their parents participated. Parents reported on their emotion regulation strategies and children reported on their depressive symptoms. Distress tolerance (DT) was assessed using the computerized distress tolerance task, the Behavioral Indicator of Resiliency to Distress. Children who were able to complete the BIRD had lower levels of depression. Analyses examining relations among father and mother emotion regulation and children's DT showed children's DT is more closely related to their mothers' than fathers' emotion regulation styles. These findings suggest that DT is an important construct in understanding children's psychopathology, but also that maternal emotion regulation is associated with children's distress tolerance.
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Affiliation(s)
- Stacey N Doan
- Department of Psychology, Claremont McKenna College, 850 Columbia Ave, Claremont, CA, USA.
| | - Heimi Son
- Department of Counseling & Psychology, Lesley University, Cambridge, MA, USA
| | - Lawrence N Kim
- Department of Psychology, Virginia Tech, Blacksburg, VA, USA
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Smith LJ, Bartlett BA, Tran JK, Gallagher MW, Alfano C, Vujanovic AA. Sleep Disturbance Among Firefighters: Understanding Associations with Alcohol Use and Distress Tolerance. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9955-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2018. [DOI: 10.1111/cpsp.12248] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Arielle Horenstein
- Adult Anxiety Clinic of Temple; Department of Psychology; Temple University; Philadelphia Pennsylvania
| | - Carrie M. Potter
- Department of Psychiatry of Cambridge Health Alliance; Harvard Medical School; Boston Massachusetts
| | - Richard G. Heimberg
- Adult Anxiety Clinic of Temple; Department of Psychology; Temple University; Philadelphia Pennsylvania
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Vujanovic AA, Farris SG, Bartlett BA, Lyons RC, Haller M, Colvonen PJ, Norman SB. Anxiety sensitivity in the association between posttraumatic stress and substance use disorders: A systematic review. Clin Psychol Rev 2018; 62:37-55. [PMID: 29778929 DOI: 10.1016/j.cpr.2018.05.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
Abstract
Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) are complex psychiatric conditions that commonly co-occur. No evidence-based, "gold standard" treatments for PTSD/SUD comorbidity are currently available. Thus, it is imperative to better understand cognitive-affective mechanisms, targetable via cognitive-behavioral intervention (i.e., malleable), that may be related to both disorders in order to improve the theory and treatment of PTSD/SUD. Anxiety sensitivity is a malleable cognitive-affective factor with relevance to both PTSD and SUD. This systematic review focused on the published literature on anxiety sensitivity and trauma/PTSD and substance use/SUD from 1966 - May 1, 2018, and includes a total of 35 manuscripts. The state of the literature, limitations, and future research directions are discussed.
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Affiliation(s)
- Anka A Vujanovic
- University of Houston, Department of Psychology, Houston, TX, USA.
| | - Samantha G Farris
- The Warren Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, RI, USA; The Miriam Hospital, Centers for Behavioral and Preventative Medicine, Providence, RI, USA; Butler Hospital, Behavioral Medicine and Addictions Research Unit, Providence, RI, USA; Rutgers, The State University of New Jersey, Department of Psychology, Piscataway, NJ, USA
| | | | - Robert C Lyons
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Moira Haller
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA
| | - Peter J Colvonen
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Sonya B Norman
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California, San Diego School of Medicine, Department of Psychiatry, San Diego, CA, USA; Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, CA, USA; National Center for PTSD, White River Junction, VT, USA
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Bedard-Gilligan M, Garcia N, Zoellner LA, Feeny NC. Alcohol, cannabis, and other drug use: Engagement and outcome in PTSD treatment. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2018; 32:277-288. [PMID: 29595297 PMCID: PMC9377391 DOI: 10.1037/adb0000355] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Abstract
The co-occurrence of posttraumatic stress disorder (PTSD) and substance use is related to poorer outcome and increased dropout from trauma-focused treatment. Investigating PTSD and substance use can inform the intervention approaches. Exploring cannabis use in particular is especially important because rates of cannabis use have been increasing with recent legalization trends. A better understanding of how substance use is associated with treatment processes and outcome for individuals with PTSD is needed to enhance care. In this study, both lifetime diagnoses of alcohol and drug use disorders and current alcohol and drug use severity were examined in 200 men and women with chronic PTSD who received either prolonged exposure (PE) or sertraline. No lifetime or current alcohol use variables predicted dropout, adherence, or poorer outcome. However, lifetime diagnosis of both an alcohol and drug disorder (OR = 3.42) and recent cannabis use (OR = 3.38) strongly predicted higher dropout. Recent cannabis use and drug use severity predicted poorer adherence to PE (β = -.22 to -.29) but not to sertraline. Drug use severity (β = -.22) also predicted worse treatment outcome, as did lifetime diagnosis of an alcohol and drug disorder (β = -.48). Overall, patients with drug use improved with treatment but had less treatment retention, adherence, and symptom reduction. Strategies to increase engagement and retention may be indicated for these patients. Individuals who are using cannabis or other drugs may be at higher risk for not completing PTSD treatment, potentially prolonging the cycle of PTSD and substance use. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - Norah C Feeny
- Department of Psychology, Case Western Reserve University
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Manning K, Paulus DJ, Hogan JBD, Buckner JD, Farris SG, Zvolensky MJ. Negative affectivity as a mechanism underlying perceived distress tolerance and cannabis use problems, barriers to cessation, and self-efficacy for quitting among urban cannabis users. Addict Behav 2018; 78:216-222. [PMID: 29216571 PMCID: PMC6421836 DOI: 10.1016/j.addbeh.2017.11.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/21/2017] [Accepted: 11/27/2017] [Indexed: 12/25/2022]
Abstract
Cannabis use rates continue to rise in the United States and currently cannabis is among the most widely used substances in the world. Cannabis use is associated with several mental health problems, low educational attainment, low income, and underemployment. The current study explored the tendency to experience negative affect (negative affectivity) as a factor accounting for the association between perceived distress tolerance and problems related to the use of cannabis. Participants included 203 urban adult daily cannabis users (29.2% female, M=37.7years, 63% African American). Results indicated that there was a significant indirect effect of distress tolerance via negative affectivity in terms of cannabis use problems (b=-0.58, 95%CI [-1.14, -0.21]), cannabis withdrawal (b=-0.65, 95%CI [-1.36, -0.21]), self-efficacy for quitting (b=-0.83, 95%CI [-1.85, -0.22]), and perceived barriers for cannabis cessation (b=-0.71, 95%CI [-1.51, -0.24]). The present data provide novel empirical evidence suggesting negative affectivity may help explain the relation between perceived distress tolerance and an array of clinically significant cannabis use processes. Intervention programming for daily cannabis users may benefit from targeting negative affectivity to facilitate change in cannabis use processes among users who tend to perceive that they are less capable of tolerating distress.
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Affiliation(s)
- Kara Manning
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Daniel J Paulus
- University of Houston, Department of Psychology, Houston, TX, United States
| | | | - Julia D Buckner
- Louisiana State University, Department of Psychology, Baton Rouge, LA, United States
| | - Samantha G Farris
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States; Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Providence, RI, United States; General Medicine Research Unit, Butler Hospital, Providence, RI, United States
| | - Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
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Keough MT, Hendershot CS, Wardell JD, Bagby RM. Investigating the mediational role of negative urgency in the anxiety sensitivity pathway to cannabis problems and dependence symptoms among postsecondary students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:69-75. [PMID: 28829279 DOI: 10.1080/07448481.2017.1369093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Anxiety sensitivity (AS) is associated with cannabis use. People high in AS may use cannabis to cope with elevated anxiety. This association is consistently supported in the literature. However, we have much to learn about the mechanisms of the AS pathway to cannabis use. We aimed to examine negative urgency-the tendency to act impulsively when distressed-as a mediator of the association of AS with cannabis problems and cannabis dependence symptoms. We hypothesized that negative urgency would uniquely mediate the association of AS with cannabis outcomes after controlling for other facets of impulsivity. PARTICIPANTS AND METHODS Postsecondary students (N = 91; Fall 2012) completed online self-reports. To participate, students needed to be ≥18 years old, enrolled in postsecondary studies, and needed to report current cannabis use. RESULTS Negative urgency uniquely mediated associations between AS and cannabis problems and dependence symptoms. CONCLUSIONS Our findings suggest a mechanistic role of negative urgency in the AS pathway to cannabis misuse.
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Affiliation(s)
- Matthew T Keough
- a Department of Psychology , University of Manitoba , Winnipeg , Manitoba , Canada
| | - Christian S Hendershot
- b Centre for Addiction and Mental Health , Campbell Family Mental Health Research Institute , Toronto , Ontario , Canada
- c Departments of Psychology and Psychiatry , University of Toronto , Toronto , Ontario , Canada
- d Department of Psychiatry , University of Toronto , Toronto , Ontario , Canada
| | - Jeffrey D Wardell
- b Centre for Addiction and Mental Health , Campbell Family Mental Health Research Institute , Toronto , Ontario , Canada
| | - R Michael Bagby
- c Departments of Psychology and Psychiatry , University of Toronto , Toronto , Ontario , Canada
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Villarosa MC, Messer MA, Madson MB, Zeigler-Hill V. Depressive Symptoms and Drinking Outcomes: The Mediating Role of Drinking Motives and Protective Behavioral Strategies Among College Students. Subst Use Misuse 2018; 53:143-153. [PMID: 28813174 DOI: 10.1080/10826084.2017.1327974] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND College students with depressive symptoms tend to engage in more hazardous drinking and experience more alcohol-related consequences to cope with their symptoms. Given the perceived tension reducing effects of alcohol among these students, it is important to explore how protective factors, such as protective behavioral strategies, account for the relationships among depressive symptoms, drinking motives, and alcohol-related outcomes. OBJECTIVE To examine the mediating role of drinking motives and protective behavioral strategies on the associations that depressive symptoms have with typical weekly alcohol consumption, hazardous drinking, and alcohol-related negative consequences in a sample of college student drinkers. METHODS Traditional age college students (n = 566, 73% women; 58% White, non-Hispanic) completed measures of depression, drinking motives, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences. RESULTS Coping with depression motives and controlled consumption PBS explained the association between depression and weekly alcohol consumption and hazardous drinking whereas coping with depression motives and serious harm reduction PBS explained the depression-negative consequences relationship. Conformity motives and serious harm reduction PBS explained the association between depression and hazardous drinking and alcohol-related negative consequences. CONCLUSIONS Findings suggest that students with more depressive symptoms would benefit from clinical interventions tailored to address negative reinforcement drinking motives and, by extension, increase student utilization of PBS related to minimizing harm. Clinical and research implications are provided.
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Affiliation(s)
- Margo C Villarosa
- a The University of Southern Mississippi , Hattiesburg , Mississipi , USA
| | - Mary Anne Messer
- a The University of Southern Mississippi , Hattiesburg , Mississipi , USA
| | - Michael B Madson
- a The University of Southern Mississippi , Hattiesburg , Mississipi , USA
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Short NA, Boffa JW, King S, Albanese BJ, Allan NP, Schmidt NB. A randomized clinical trial examining the effects of an anxiety sensitivity intervention on insomnia symptoms: Replication and extension. Behav Res Ther 2017; 99:108-116. [PMID: 29035703 PMCID: PMC6397652 DOI: 10.1016/j.brat.2017.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/28/2017] [Accepted: 09/29/2017] [Indexed: 11/17/2022]
Abstract
Insomnia disorder is impairing and prevalent, particularly among individuals with comorbid anxiety disorders. Despite the availability of effective computerized treatments for insomnia, there are few that target both insomnia as well as co-occurring anxiety symptoms. The current study tests the efficacy of a computerized treatment for anxiety sensitivity cognitive concerns, a transdiagnostic risk factor for anxiety, mood, and insomnia symptoms, against a repeated contact control, on reducing insomnia symptoms. Hypotheses were tested in a mixed clinical sample of community individuals presenting for a treatment study (n = 151) who were followed up 1-, 3- and 6-months after treatment. Results indicated that the anxiety sensitivity intervention resulted in reductions in insomnia symptoms and clinically significant insomnia scores at 3- and 6-month follow-ups. These reductions remained significant when covarying for concurrent reductions in depression and anxiety. Models accounted for 15-54% of the variance in follow-up insomnia symptoms. Current findings add to a growing body of literature suggesting anxiety sensitivity may play a causal role in insomnia symptoms. Results also suggest that targeting anxiety sensitivity may be an effective way to reduce insomnia symptoms in a brief and portable intervention that also reduces symptoms commonly comorbid with insomnia disorder.
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Affiliation(s)
| | | | - Savannah King
- Department of Psychology, Florida State University, USA
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Associations of anxiety sensitivity and emotional symptoms with the subjective effects of alcohol, cigarettes, and cannabis in adolescents. Addict Behav 2017; 73:192-198. [PMID: 28544955 DOI: 10.1016/j.addbeh.2017.05.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 12/26/2022]
Abstract
Maladaptive emotional traits (anxiety sensitivity [AS], fear of anxiety-related sensations and consequences) and symptoms (major depressive disorder [MDD] and generalized anxiety disorder [GAD] symptoms) could play a role in altering sensitivity to the subjective effects of drugs of abuse in adolescents. Data were drawn from a longitudinal study of high school students in Los Angeles, CA, USA who completed surveys and reported past six-month use of alcohol (n=1054), cigarettes (n=297), or cannabis (n=706). At each of the four semi-annual waves during mid-adolescence (14-16years old), students reported positive and negative subjective drug effects experienced in the prior six-months. Controlling for covariates and the simultaneous covariance across the three domains of emotional dysfunction, AS was associated with more positive and negative cannabis effects (βs=0.09-0.16, ps<0.05), and MDD symptoms were associated with fewer negative cigarette effects (β=-0.13, p=0.04) and more negative cannabis effects (β=0.10, p=0.004). The acceleration of positive alcohol and cannabis effects over time was slower among adolescents with higher baseline MDD (MDD×time: β=-0.04, p=0.044) and GAD (GAD×time: β=-0.05, p=0.03) symptoms, respectively. These findings suggest that emotional dysfunction factors show differential and overlapping effects on subjective drug effects, which may vary across time. Future research should investigate emotional dysfunctions and subjective drug effects in relation to substance use across adolescence and emerging adulthood.
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Buckner JD, Walukevich KA, Zvolensky MJ, Gallagher MW. Emotion regulation and coping motives serially affect cannabis cessation problems among dually diagnosed outpatients. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2017; 31:839-845. [PMID: 28846000 DOI: 10.1037/adb0000310] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Little empirical work has evaluated why anxious cannabis users are especially vulnerable to poorer cannabis cessation outcomes. Presumably, these individuals rely on cannabis because they have difficulties with emotion regulation and they therefore use cannabis to manage their negative emotions. The current study examined the direct and indirect effects of anxiety severity on a range of cannabis cessation variables among 79 (63.3% non-Hispanic White; 43.0% female) adults with anxiety disorders seeking outpatient treatment for cannabis use disorder. The independent and serial indirect effects of difficulties with emotion regulation and coping motives were examined in relation to the anxiety-cannabis variables. Anxiety severity was directly and robustly related to greater cannabis withdrawal symptom severity, less self-efficacy to refrain from using cannabis in emotionally distressing situations, and more reasons for quitting. Anxiety was indirectly related to cannabis outcomes via the serial effects of emotion regulation and coping motives. These findings document the important role of emotion regulation and coping motives in the relations of anxiety with cannabis cessation variables among dually diagnosed outpatients. (PsycINFO Database Record
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