Addiction as an Attachment Disorder: White Matter Impairment Is Linked to Increased Negative Affective States in Poly-Drug Use

Nothing about us without us! How users configure clinical treatment in Italian residential communities: ethnography of therapeutic engagement

The effectiveness of the interventions in the Therapeutic communities (TC) depends not only on the quality of the specialized knowledge and methodologies adopted, but also on the meanings consumers give to them. Building the therapeutic alliance is a key element in reducing high drop-out rates and predicting more favorable outcomes. This research investigated the discourses practiced by 45 people with substance use disorders who had been accessing a therapeutic community for less than 15 days, with the aim of delving into the meanings given to treatment and pathway goals in the service, to analyze what theories are used to explain consumption and therapeutic change. The study made use of Discourse analysis (DA) and Positional theory with a protocol of written open-ended questions. The results show how participants configure the community pathway adopting a passive role, underestimating the need to co-participate in treatment design and bringing in poorly formalized goals. The collected texts provide a better understanding of the perspective of community users, emphasizing the need to share spaces of co-design from the very beginning in order to promote empowering, reasoning about the implications of the various discourses produced by consumers to explain their autobiography and to envision paths of change.

How "Light" Is "Light Smoking"? On the Cognitive Power of Nicotine Dependence

In recent years, habits related to smoking have been changing. An increasing portion of light/occasional smokers tend to define themselves as non-smokers, leading to an incorrect perception of the risks that smoking even a few cigarettes can entail. In this study, we investigated the nicotine-induced cognitive distortion in young, higher-education students with low/moderate dependence (as indexed by the Fagerstrom questionnaire). The study involved 111 participants (62 female; mean age 24.43 ± 3.77) divided into smokers and non-smokers, who responded to specific questionnaires to evaluate their attachment style, emotion dysregulation, and state anxiety. Their response to smoking-related cues following emotional stimulation was experimentally evaluated, with participants being made to choose between care- or smoking-related images, following the presentation of threatening or neutral stimuli. The results show a cognitive bias in smokers, with participants choosing smoking-related stimuli significantly more often than non-smokers, with a slower reaction time, regardless of emotional cues. Emotion dysregulation and attachment style were also significantly correlated with response choice but not with response latency. Overall, our data indicate that there is no such thing as light use of nicotine and that smoking, even if not continuous, determines cognitive biases that lead to a vision of the environment as a function of substance seeking.

Affective neuroscience personality traits in opioid use disorder patients: The relationship with earlier onset of substance use, the severity of addiction, and motivational factors to quit opiate use

INTRODUCTION

This study aims to explore the relationship between affective personality traits and opioid use disorder (OUD), including factors such as motivation to quit, addiction severity, and age of onset of drug use.

METHODS

This study included 141 patients with opioid addiction (OAP) and 160 age- and sex-matched healthy controls (HC). OAP were interviewed and diagnosed according to DSM-5 criteria. HC were screened for past or current drug use. Participants completed sociodemographic forms and the Affective Neuroscience Personality Scale (ANPS), and the OAP group also completed the Addiction Profile Index (API).

RESULTS

SEEK, PLAY, and SADNESS were identified as different affective personality traits between OAP and HC groups. Addiction severity was positively correlated with SADNESS and ANGER, while the age of onset of drug use was correlated with ANGER. Risk factors for OA include family history of substance abuse, low education, and low PLAY scores, whereas risk factors for earlier substance use onset are childhood trauma and high ANGER scores.

CONCLUSIONS

This study highlights the importance of understanding affective personality traits in OUD. These findings may deepen our understanding of the underlying mechanisms of OUD. The identification of these affective systems may have implications for the development of personalized prevention and treatment strategies.

Influence of anxious attachment on the relationship between primary emotions and substance-related addictive behaviors

Objectives

To date there is no universally accepted model that describes the development of substance related addictive behavior. In order to address this gap, the study sought to examine whether the association between primary emotions and the inclination toward addictive behavior is mediated by an anxious attachment style.

Methods

The total sample consisted of 900 German speaking non-clinical adults (age: M = 27; SD = 9.60; 71.6% female). Structural Equation Modeling (SEM) was applied to examine the connection between the primary emotions (SADNESS and ANGER), and the latent variables attachment anxiety and symptoms of addictive behavior.

Results

Substance use symptomatology was correlated with higher attachment anxiety (r = 0.15), SADNESS (r = 0.15), and ANGER (r = 0.11). The effect of SADNESS on addictive behavior is mediated by attachment anxiety (p < 0.01) whereas ANGER had a direct effect on addictive behavior (p < 0.01). The final SEM explains 4% of the variance of addictive behaviors and 22% of attachment anxiety.

Conclusion

Our findings suggest that both SADNESS and ANGER, along with attachment anxiety, are dispositions that contribute to the risk of engaging in addictive behavior. However, while ANGER directly influences addictive behavior, SADNESS acts through its impact on attachment anxiety.

Reports of self-compassion and affect regulation in psilocybin-assisted therapy for alcohol use disorder: An interpretive phenomenological analysis

OBJECTIVE

The primary aim of this qualitative study was to delineate psychological mechanisms of change in the first randomized controlled trial of psilocybin-assisted psychotherapy to treat alcohol use disorder (AUD). Theories regarding psychological processes involved in psychedelic therapy remain underdeveloped.

METHOD

Participants (N = 13) mostly identified as non-Hispanic and White, with approximately equal proportions of cisgender men and women. Participants engaged in semistructured interviews about their subjective experiences in the study. Questions probed the nature of participants' drinking before and after the study as well as coping patterns in response to strong emotions, stress, and cravings for alcohol. Verbatim transcripts were coded using Dedoose software, and content was analyzed with interpretive phenomenological analysis.

RESULTS

Participants reported that the psilocybin treatment helped them process emotions related to painful past events and helped promote states of self-compassion, self-awareness, and feelings of interconnectedness. The acute states during the psilocybin sessions were described as laying the foundation for developing more self-compassionate regulation of negative affect. Participants also described newfound feelings of belonging and an improved quality of relationships following the treatment.

CONCLUSION

Our results support the assertion that psilocybin increases the malleability of self-related processing, and diminishes shame-based and self-critical thought patterns while improving affect regulation and reducing alcohol cravings. These findings suggest that psychosocial treatments that integrate self-compassion training with psychedelic therapy may serve as a useful tool for enhancing psychological outcomes in the treatment of AUD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is there an affective neuroscience of spirituality? The development and validation of the OCEANic feelings scale

Background

Oceanic feelings represent a phenomenological structure of affective sensations that characteristically involve feelings of self-dissolution and feelings of unity and transcendence. This study presents the preliminary version of a self-report instrument to measure individual dispositions toward oceanic feelings in order to enable further research within the concept of primary emotions postulated by Jaak Panksepp.

Methods

A first version of the questionnaire was applied to a total sample of 926 German-speaking adults of the general population. After performing item analysis and principal component analysis (PCA) in a first study (N = 300), the questionnaire was shortened. In a second study (N = 626), confirmatory factor analysis (CFA) was conducted and emerged scales were related to the already established instruments for the assessment of primary emotions (BANPS-GL) and Big Five personality traits (BFI-44).

Results

The OCEANic scale exhibited reliabilities ranging from Cronbach's α = 0.82 (positive) to α = 0.88 (negative) and plausible correlations with behavioral traits related to the seven affective neurobiological systems (ANGER, FEAR, CARE, SEEK, PLAY, SADNESS, and LUST) as well as with personality factors measured by the Big Five Inventory. For CFA, a bifactorial model with an overall factor demonstrated good fit: RMSEA = 0.00 (90% CI:0.00, 0.03); TLI = 1.00; CFI = 1.00; NFI = 0.99.

Discussion

The OCEANic scale enables the operationalization of oceanic feelings comprising two subscales and one total scale. The results indicate good reliability and acceptable factorial validity. Establishment and further validation of the OCEANic scale within future research will be needed to fully understand the role of oceanic feelings within the human affective life, especially the personality trait of spirituality.

The Effect of Dehydroepiandrosterone Administration during Rehabilitation on White Matter Integrity Among Individuals With Polysubstance Use Disorder

OBJECTIVES

Individuals with polysubstance use disorder (pSUD) exhibit vulnerability to relapse even after prolonged abstinence, with rehabilitation efforts achieving limited success. Previous studies highlighted dehydroepiandrosterone (DHEA) as a putative therapeutic agent that may aid rehabilitation, potentially by impacting white matter (WM) properties. The current study tested, for the first time, the effect of DHEA administration during rehabilitation on WM integrity among pSUD individuals, while assessing its putative association with long-term relapse rates.

METHODS

Immediately after admission to rehabilitation, 30 pSUD individuals were assigned to receive either placebo or DHEA (100 mg) daily for 3 months, via a randomized double-blind counterbalanced design. Participants also provided blood samples to assess circulating DHEA levels at treatment initiation and completed a diffusion tensor imaging (DTI) scan approximately 1 month after treatment initiation. Clinical status was evaluated 16 months after treatment initiation. Thirty matched healthy controls also underwent a DTI scan without any intervention.

RESULTS

DHEA administration was not associated with reduced relapse rates compared with placebo. Nevertheless, exploratory analysis revealed that DHEA was associated with successful rehabilitation among pSUD individuals with low circulating DHEA levels at treatment initiation. White matter integrity in the splenium corpus callosum (CC) was reduced in pSUD individuals compared with healthy controls, yet pSUD individuals receiving DHEA exhibited recovery of splenium CC WM integrity.

CONCLUSIONS

DHEA administration during rehabilitation may restore WM integrity in the CC among pSUD individuals. Although DHEA was not associated with reduced relapse rates in here, its therapeutic efficacy may depend on circulating DHEA levels at treatment initiation.

On the trail of Sisyphus - addiction as an existential neurosis?

In Greek mythology, Sisyphus, king of the Corinthians, dared to deceive the gods and was condemned to roll a boulder to the top of a mountain for all eternity. Shortly before reaching the summit, however, the boulder rolled back down into the valley, and the arduous task had to begin anew. Many of the contents of this classic myth are reminiscent of the therapeutic approach to addictive disorders. In addiction therapy, too, it is often a long and rocky road that ends with a relapse. The therapeutic effort was not entirely in vain, but one often begins to doubt its usefulness. In terms of Sisyphus and a Bio-Psycho-Social Model (BPSM) of health and disease, addiction can be located at the end of a downward spiral. By extension of the BPSM, can addictive disease be considered an expression of existential neurosis? The results of our own research speak in favor of this and show a clearly reduced experience of sense and meaning, but also diminished feelings of hope and forgiveness in addiction patients. However, positive correlations between various parameters of existential well-being and mental health or more appropriate stress coping are also found for the addiction group. These results are supported by neuronal correlates and are mirrored in the general population. Based on this, the consideration of existential issues in addiction therapy can be discussed. Finally, the use of art therapy and work training are proposed as examples of a meaning based therapeutic intervention in dealing with people with addictive diseases.

Attachment Trauma Is Associated with White Matter Fiber Microstructural Alterations in Adolescents with Anorexia Nervosa before and after Exposure to Psychotherapeutic and Nutritional Treatment

In the present study, we explore the role of attachment for microstructural white matter (WM) changes in adolescents with anorexia nervosa (AN) before and after exposure to short-term and nutritional treatment. The case sample consisted of 22 female adolescent inpatients with AN (mean age: 15.2 ± 1.2 years) and the control sample were 18 gender-matched healthy adolescents (mean age: 16.8 ± 0.9 years). We performed a 3T MRI in the patient group during the acute state of AN and after weight restoration (duration: 2.6 ± 1 months) and compared the data to a healthy control group. To classify attachment patterns, we used the Adult Attachment Projective Picture System. In the patient sample, over 50% were classified with an attachment trauma/unresolved attachment status. Prior to treatment exposure, fractional anisotropy (FA) reductions and concordant mean diffusivity (MD) increases were evident in the fornix, the corpus callosum and WM regions of the thalamus, which normalized in the corpus callosum and the fornix post-therapy in the total patient sample (p < 0.002). In the acute state, patients with an attachment trauma demonstrated significant FA decreases compared to healthy controls, but no MD increases, in the corpus callosum and cingulum bilaterally, which remained decreased after therapy. Attachment patterns seem to be associated with region-specific changes of WM alterations in AN.

Affective Neuroscience Personality Scale (ANPS) and clinical implications: A systematic review

BACKGROUND

Affective neuroscience (AN) theory assumes the existence of seven basic emotional systems (i.e., SEEKING, ANGER, FEAR, CARE, LUST, SADNESS, PLAY) that are common to all mammals and evolutionarily determined to be tools for survival and, in general, for fitness. Based on the AN approach, the Affective Neuroscience Personality Scales (ANPS) questionnaire was developed to examine individual differences in the defined basic emotional systems. The current systematic review aims to examine the use of ANPS in clinical contexts attempting to define those behavioral elements associated with underlying stable personality traits.

METHODS

The systematic review was conducted following the PRISMA statements. PubMed and PsycInfo were used for research literature from March 2003 to November 2021.

RESULTS

Forty-four studies including ANPS were identified from 1763 studies reviewed. Sixteen studies met the inclusion criteria.

LIMITATIONS

The review comprised some papers with incomplete psychological assessments (e.g., lack of other measures in addition to the ANPS) and missing information (e.g., on the [sub]samples), which may affect the generalizability of findings.

CONCLUSION

Specific endophenotypes and/or patterns of emotional/motivational systems were found for several mental disorders. Specifically, endophenotypes emerged for the Depressive and Autism Spectrum Disorders, Borderline and Avoidant Personality Disorders, type I and II Bipolar Disorders, and the Obsessive-Compulsive Disorder. The endophenotypes can provide useful reflective elements for both psychodiagnosis and intervention. Overall, the current study may represent an attempt to contribute to the understanding of the basic emotional systems involved in the psychopathological manifestations identified by AN.

The neuroscience of spirituality, religion, and mental health: A systematic review and synthesis

Prior research highlights the importance of spirituality/religion (S/R) as it relates to several aspects of mental health and clinical interventions. This research has been expanded to include the concurrent examination of neurobiological correlates of S/R to elucidate potential biological mechanisms. However, the majority of neurobiological research on S/R has neglected mental health, and the relationship across all three of these domains (S/R, mental health, and neurobiology) remains unclear. This study systematically reviewed research concurrently examining S/R, mental health, and neurobiology, and rated the methodological quality of included studies. Eighteen identified studies were then included in an integrated literature review and discussion, regarding the neurobiological correlates of S/R as it pertains to depression, anxiety, alcohol/substance misuse, and psychosis. The majority of studies demonstrated moderate to high methodological quality. Findings highlight the need for additional studies in this area as well as research that includes validated assessment of S/R.

Attachment and Therapeutic Alliance in Substance Use Disorders: Initial Findings for Treatment in the Therapeutic Community

Background: There is convincing evidence that individuals suffering from Substance Use Disorder (SUD) often present insecure attachment patterns. In contrast, a strong therapeutic alliance in treatment of SUD has been found to lead to a more positive treatment outcome. However, insecure attachment has been observed to be linked with weaker therapeutic alliance strength. The primary aim of this explorative study was to gain initial insights regarding the influence of attachment and personality characteristics on therapeutic alliance and therapy motivation in SUD patients undergoing treatment at a therapeutic community. Furthermore, SUD patients were compared to healthy controls regarding attachment, personality and mood pathology. Methods: A total sample of 68 participants, 34 inpatients in SUD treatment and 34 age-gender and education adjusted controls, were investigated. Both groups filled in the Adult Attachment Scale (AAS), the Inventory of Personality Organization (IPO-16), and the Brief Symptom Inventory (BSI-18) questionnaires. Additionally, SUD patients filled in the Working Alliance Inventory (WAI-SR) and the adapted German version of the University of Rhode Island Change Assessment scale (FEVER). Results: In line with our assumptions, SUD patients exhibited a decreased amount of attachment security (AAS) which was related to higher personality (IPO-16) and mood pathology (BSI-18). Furthermore, correlational analysis revealed the WAI-SR dimension Bond being positively associated with more secure attachment. A strong task alliance was linked to the Action stage of change (FEVER) and decreased mood but not personality pathology. Conclusion: Our findings confirm the putative negative effect of attachment and personality pathology on therapy motivation and therapeutic alliance in addiction therapy as well as more specifically in therapeutic community treatment. Future research in enhanced samples might focus more on the long-term effects of the interaction of attachment, personality and therapeutic alliance variables.

Early parent-child interactions and substance use disorder: An attachment perspective on a biopsychosocial entanglement

This review aims to elucidate environmental and genetic factors, as well as their epigenetic and neuroendocrine moderators, that may underlie the association between early childhood experiences and Substance Use Disorders (SUD), through the lens of parental attachment. Here we review those attachment-related studies that examined the monoaminergic systems, the hypothalamic pituitary adrenal stress response system, the oxytoninergic system, and the endogenous opioid system from a genetic, epigenetic, and neuroendocrine perspective. Overall, the selected studies point to a moderating effect of insecure attachment between genetic vulnerability and SUD, reasonably through epigenetic modifications. Preliminary evidence suggests that vulnerability to SUDs is related with hypo-methylation (e.g. hyper-expression) of high-risk polymorphisms on the monoaminergic and hypothalamic pituitary adrenal system and hyper-methylation (e.g. hypo-expressions) of protective polymorphisms on the opioid and oxytocin system. These epigenetic modifications may induce a cascade of neuroendocrine changes contributing to the subclinical and behavioural manifestations that precede the clinical onset of SUD. Protective and supportive parenting could hence represent a key therapeutic target to prevent addiction and moderate insecure attachment.

Lower cognitive reappraisal capacity is related to impairments in attachment and personality structure in poly-drug use: an fMRI study

Insecure attachment, impaired personality structure and impaired emotion regulation figure prominently in substance use disorders. While negative emotions can trigger drug-use and relapse, cognitive reappraisal may reduce emotional strain by promoting changes in perspective. In the present study, we explored behavioral and neural correlates of cognitive reappraisal in poly-drug use disorder by testing individuals' capability to generate cognitive reappraisals for aversive events (Reappraisal Inventiveness Test). 18 inpatients with poly-drug use disorder and 16 controls completed the Adult Attachment Scale, the Emotion Regulation Questionnaire, the Brief Symptom Inventory, the Wonderlic Personnel Test, and the Operationalized Psychodynamic Diagnosis Structure Questionnaire, as well as two versions of the Reappraisal Inventiveness Test (during fMRI and outside the lab). Compared to controls, polydrug inpatients reported impaired personality structure, attachment and emotion regulation abilities. In the Reappraisal Inventiveness Test, poly-drug inpatients were less flexible and fluent in generating reappraisals for anger-eliciting situations. Corresponding to previous brain imaging evidence, cognitive reappraisal efforts of both groups were reflected in activation of left frontal regions, particularly left superior and middle frontal gyri and left supplemental motor areas. However, no group differences in neural activation patterns emerged. This suggests that despite cognitive reappraisal impairments on a behavioral level, neural reflections of these deficits in poly-drug use disorder might be more complex.

Maternal pre- and postnatal substance use and attachment in young children: A systematic review and meta-analysis

Maternal substance use has often been associated with insecure and disorganized child attachment. We evaluated this association with a meta-analysis of young children and, further, systematically reviewed mediating and moderating factors between maternal substance use and child attachment. We performed a systematic database search of quantitative English language studies on child attachment that included substance-using mothers and their children below 6 years of age. Eleven studies (N = 1,841) met the inclusion criteria and were included in the meta-analysis of attachment security and seven (N = 1,589) studies were included in the meta-analysis of attachment disorganization. We found that maternal substance use was negatively associated with secure attachment in children, but the effect size was small (r = -.10). The association with disorganized attachment was not significant (r = .15). Related to moderating and mediating factors (k = 6), we found evidence on the role of teratogenic and sociological factors on child attachment. Most importantly, the impact of cumulative risks was vital. However, literature was scarce, and studies varied in risk of bias, leaving many unanswered questions on other potential factors underlying the development of attachment in these high-risk children. We discuss the results considering clinical implications and future directions.

A comprehensive review of studies using the Affective Neuroscience Personality Scales in the psychological and psychiatric sciences

Jaak Panksepp's Affective Neuroscience Theory (ANT) belongs to the most prominent emotion theories in the psychological and psychiatric sciences. ANT proposes the existence of seven primary emotional systems deeply anchored in the mammalian brain. These emotional/motivational systems have been shaped by evolutionary processes and function as tools for survival in mammalian species. The systems are called SEEKING, LUST, CARE, and PLAY, as well as ANGER, FEAR, and SADNESS. Panksepp carved out these emotional systems via means of deep brain stimulation, brain lesion and pharmacological manipulation studies. Davis et al. (2003) designed the Affective Neuroscience Personality Scales (ANPS) against the background of findings from ANT. This self-report inventory is meant to enable researchers to assess individual differences in primary emotional systems. Seventeen years have passed since the first version of the ANPS has been published. Therefore, we now provide a comprehensive overview on studies using the ANPS including work from personality science, psychiatry and the neurosciences.

Attachment Styles, Personality Organization, and Substance Use as Predictors of Emotion Regulation Strategies "Suppression" and "Reappraisal" in Young Adults

BACKGROUND

As evidenced by current literature, there is a crucial link between emotion regulation, attachment, personality patterns, and substance abuse. However, knowledge regarding the exact interactions of these specific parameters in terms of substance abuse development is still sparse. Therefore, this study is aimed to shed light on how two specific emotion regulation strategies ("Reappraisal" and "Suppression") might be influenced by the relationship between attachment, structural deficits in personality organization, and addictive behaviors.

METHOD

A total sample of 299 non-clinical young adults (Age: M = 22; SD = 3.81; 74.2% females) filled in the Emotion Regulation Questionnaire (ERQ) together with the Adult Attachment Scale (AAS), the Personality Organization Inventory (IPO-16), and the Alcohol, Smoking and Substance Involvement Screening (ASSIST) by means of an online survey.

RESULTS

As suggested by hierarchical regression analysis, attachment specifically predicted differences in Emotion Regulation (ER), whereby the AAS subscales "Close" ness (β = -0.38, p < 0.01) and "Depend" ence (β = -0.18, p < 0.01) were negatively associated with increased use of maladaptive strategies of expressional suppression of emotion, and "Depend" (β = 0.26, p < 0.01) was positively associated with increased use of adaptive strategies of cognitive reappraisal.

DISCUSSION

In line with our assumptions, we observed a more secure attachment system to be predictive for an increased use of adequate emotion regulation strategies. The findings support the suggestion that a focus on underlying attachment-related processes in a psychotherapeutic setting might be a promising way to promote adaptive self-regulation of emotions.

Women in Christian Substance Abuse Treatment; Forgiveness, Attachment Styles, and Improvements in Co-occurring Mental Health Symptoms

The purpose of this study was to explore the efficacy of The Recovery Center at Shalom House Ministries and examine the relationship(s) between forgiveness, attachment styles, drug and alcohol abuse, self-reported mental health symptoms, and cognitive functioning. Participants (N = 118 women) attended Shalom Recovery (2016-2018). Statistically significant improvement was found between entrance and the 3-month mark on all measures, with 67.9% completing the program. Findings indicated that the revenge motivations correlated with depression, self-esteem, anxiety, and avoidance of intimacy with God, but only this latter scale contributed to a multiple regression model on revenge motivations at program entry.

Reward sensitivity, affective neuroscience personality, symptoms of attention-deficit/hyperactivity disorder, and TPH2-703G/T (rs4570625) genotype

OBJECTIVE

Reward sensitivity is an increasingly used construct in psychiatry, yet its possible inner structure and relationship with other affective variables are not well known.

METHODS

A reward sensitivity measurement scale was constructed on the basis of large item pool collected from birth cohort representative samples (the Estonian Children Personality Behaviour and Health Study; original n = 1238). Affective Neuroscience Personality Scale (ANPS) and the Adult Attention deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS) were administered in young adulthood. A variant (rs4570625) of the gene encoding tryptophan hydroxylase 2 (TPH2) that is responsible for the synthesis of central serotonin was genotyped.

RESULTS

Reward sensitivity consisted of two orthogonal components, operationally defined as Openness to Rewards and Insatiability by Reward, that respectively characterise the striving towards multiple rewards and the strong pursuit and fixation to a particular reward. While SEEKING and PLAY (and to lower extent CARE) of the ANPS co-varied with Openness to Rewards, FEAR, SADNESS, and ANGER were related to Insatiability by Reward. The total score of ASRS was moderately correlated with Insatiability by Reward, while the association with Openness to Rewards was negligible. However, ASRS Inattention had some negative relationship with the Social Experience facet of Openness to Rewards. The T/T homozygotes for the TPH2 promoter polymorphism had lower Insatiability by Reward but not Openness to Rewards.

CONCLUSIONS

Behaviours sensitive to rewards are separable to the components of variability and fixation, and these components are differentially related to affective aspects of personality, attention, and hyperactivity as well as to TPH2 genotype.

Pinpointing Neural Correlates of Attachment in Poly-Drug Use: A Diffusion Tensor Imaging Study

An increasing amount of evidence indicates the significance of attachment in the etiology of poly-drug use disorder (PUD). The aim of this study was to investigate associations between PUD and adult attachment in particular, with a focus on white matter (WM) fiber tract integrity. For this purpose, we selected several regions-of-interest based on previous findings which were examined for their role in PUD and estimated whole-brain associations between adult attachment and WM integrity. A total sample of 144 right-handed males were investigated (Age: M = 27; SD = 4.66). This included a group of patients diagnosed with PUD (n = 70) and a group of healthy controls (HC; n = 74). The Adult Attachment Scales (AAS) was applied to assess attachment attitudes in participants. Diffusion Tensor Imaging was used to investigate differences in WM integrity. The findings suggest substantially less attachment security in PUD patients compared to HC. Furthermore, PUD patients exhibited reduced integrity in WM fiber tracts, most pronounced in the bilateral corticospinal tract, the fronto-occipital fasciculus, and the right inferior longitudinal fasciculus. However, these results were not controlled for comorbid depressiveness. With regard to associations between adult attachment and WM integrity, the results for PUD patients indicate a negative relationship between "Comfort with Closeness" and the structural integrity of a cluster comprising parts of the right anterior thalamic radiation, the inferior fronto-occipital fasciculus and the uncinate fasciculus. Despite being limited by the cross-sectional design of this study, the results emphasize the significance of attachment in PUD etiology, both at a behavioral and a neurological level. Largely in line with previous research, the findings revealed tentative links between adult attachment and WM fiber tracts related to cognitive and affective functions in PUD patients.

Childhood Trauma, Personality, and Substance Use Disorder: The Development of a Neuropsychoanalytic Addiction Model

BACKGROUND

While traditional psychoanalysis has been criticized as insufficient for the treatment of substance use disorder (SUD), recent progress in the field of neuropsychoanalysis has generated new and promising hypotheses regarding its etiology. However, empirical research applying this framework has been sparse.

AIM AND SCOPE

The present overview aims at developing and empirically validating a neuroscientifically informed psychodynamic framework regarding the etiology of SUD. For this purpose, this review provides a concise overview of the most relevant historical and contemporary psychoanalytic theories on SUD etiology. Furthermore, the original research summarized in this paper consists of three studies investigating connections between childhood trauma, primary emotions, personality structure and attachment, as well as their relation to SUD development and treatment.

CONCLUSIONS

The results highlight the empirical validity of the neuropsychoanalytic approach towards SUD etiology. In particular, the findings underscore the conceptualization of SUD as a disorder related to dysfunctional attachment and affect regulation abilities especially linked to increased SADNESS and ANGER dispositions, which mediated the relationship between SUD and traumatic childhood relationships. Based on these findings, a refined model of SUD etiology is proposed, which should be tested in future studies.

The relationship between existential well-being and mood-related psychiatric burden in Indian young adults with attachment deficits: a cross-cultural validation study

BACKGROUND

Attachment and spirituality are thought to have deep evolutionary roots but are always interpreted within the framework of culture, religion and personal beliefs. While insecure attachment has been observed to be positively related with psychopathology, a positive mental health effect has often been described for spirituality. To examine the cross-cultural validation of previous research focused on Austrian young adults with Western socialization, we attempt to replicate our study examining the influence spirituality has on the connection between insecure attachment and mood-related psychiatric burden with Indian young adults.

METHODS

We investigated Avoidant (AV) and Anxious (AX) Attachment (ECR-RD), Religious (RWB) and Existential (EWB) Well-Being (MI-RSWB), and mood-related psychiatric burden (Anxiety, Depression, Somatization; BSI-18) in 443 (31% female) Indian young adults (age range: 18-30 years) with a Hindu upbringing.

RESULTS

Compared to young adults with a Roman Catholic upbringing in a Western socialization, Indian participants did not differ in AX and EWB but scored higher in mood-related psychiatric burden (eta2 = .04), AV (eta2 = .14), as well as RWB (eta2 = .28; all p < .01). As in previous research only AX (β = .40) positively predicted mood-related psychiatric burden (ΔR2 = .15, all p < .01), while EWB was an additional negative predictor (β = -.11, p < .05).

CONCLUSIONS

Our findings emphasize the universal importance of attachment and spirituality for mental health as well as the potential influence of socialization on their development. Furthermore, they underline that Existential Well-Being - including hope for a better future, forgiveness, and the experience of sense and meaning - appears to have a compensating effect on the relation between insecure attachment and impaired mental health.

The Therapeutic Community: A Unique Social Psychological Approach to the Treatment of Addictions and Related Disorders

The evolution of the contemporary Therapeutic Community (TC) for addictions over the past 50 years may be characterized as a movement from the marginal to the mainstream of substance abuse treatment and human services. TCs currently serve a wide array of clients and their diverse problems; through advances in research in treatment outcomes, the composition of staff has been reshaped, the duration of residential treatment has been reduced, the treatment goals have been reset and, to a considerable extent, the approach of therapy itself has been modified. An overview of the TC as a distinct social-psychological method for treating addiction and related disorders is provided by this paper. Included in this is a focus on the multifaceted psychological wounds that consistently show a strong association with addiction and thereby require initiating a recovery process characterized by life-style and identity changes.

Attachment Patterns in Subjects Diagnosed With a Substance Use Disorder: A Comparison of Patients in Outpatient Treatment and Patients in Therapeutic Communities

The purpose of the present study is to analyze the quality of attachment in substance abuse patients in outpatient treatment vs. patients in therapeutic communities in order to identify the role of attachment insecurity in choosing a care system. The sample consisted of 127 subjects (107 males and 20 females); 97 were outpatients (83 males) and 30 therapeutic community patients (24 males). Attachment with respect to current, significant relationships was assessed using the Relationship Questionnaire. In the outpatient subgroup, the prevailing attachment style was preoccupied; for the therapeutic community patients, the prevailing attachment style was dismissive. The dimensions of care (how the caregiver is perceived as loving and caring) and overprotection (how the caregiver is perceived as intrusive and interfering)-evaluated by means of the Parent Bonding Instrument-were higher in the outpatient subgroup. Scores were higher with respect to maternal subscales regardless of treatment modality. No differences emerged with respect to self-perceived symptoms (SCL-90-R) between the subgroups; however, fearful-avoidant and dismissive-avoidant individuals reported higher self-perceived symptom regardless of treatment modality. Understanding the distribution of different attachment patterns with respect to the treatment modality may improve efficacious interventions, attuning them to the individual and his or her developmental environment.

Brain Structure Alterations in Poly-Drug Use: Reduced Cortical Thickness and White Matter Impairments in Regions Associated With Affective, Cognitive, and Motor Functions

Substance use disorders (SUDs) are defined by obsessive and uncontrolled consumption, which is related to neurobiological changes. Based on previous work, this study investigated potential alterations in brain structure in poly-drug use disordered (PUD) patients in comparison to controls from the normal population. This study involved a sample of 153 right-handed men aged between 18 and 41 years, comprising a clinical group of 78 PUD and a group of 75 healthy controls. Group differences in gray matter (GM) and white matter (WM), as well as cortical thickness (CT), were investigated by means of diffusion tensor imaging using automated fiber quantification (AFQ) and voxel-based morphometry. We observed significant WM impairments in PUD, especially in the bilateral corticospinal tracts and the inferior longitudinal fasciculi. Furthermore, we found reduced CT in the PUD group especially in the left insular and left lateral orbitofrontal cortex. There were no group differences in GM. In addition, PUD exhibited a higher amount of psychiatric symptoms (Brief Symptom Inventory) and impairments in cognitive functions (Wonderlic Personnel Test). In line with previous research, this study revealed substantial impairments in brain structure in the PUD group in areas linked with affective, cognitive, and motor functions. We therefore hypothesize a neurologically informed treatment approach for SUD. Future studies should consequently explore a potential positive neuroplasticity in relation to a better therapeutic outcome.

The Role of Attachment in Poly-Drug Use Disorder: An Overview of the Literature, Recent Findings and Clinical Implications

Background: Substance use disorders (SUDs) represent a worldwide epidemic with extensive costs to the individual and to society. Occasionally described as an attachment disorder, they have been linked to various impairments in self-regulation and social functioning. However, while there have been significant advances in the development and validation of treatment strategies for SUD in recent years, the components of these treatment approaches have yet to be fully explored. The characteristics of polydrug use disorder (PUD) especially need to be addressed in more detail, as this diagnosis is highly common in individuals seeking treatment, while simultaneously being associated with poor treatment success. Aim and Scope: This review aims at further exploring the relevance of attachment in PUD and its treatment. To this end, this review provides a concise summary of relevant theories on the development and treatment of SUD in general, including related parameters of attachment, emotion regulation, and neuroscience. Furthermore, several studies focused specifically on PUD are described in more detail. These studies explored the connections between attachment, personality structure, primary and higher emotions (including spirituality), as well as structural and functional neural parameters in inpatients with PUD as well as in healthy controls. Most notably, the described studies highlight that insecure attachment and impairments in personality structure are present in inpatients with PUD. In addition, these characteristics are paralleled by extensive impairments in white matter integrity, especially in tracts connected to facets of emotion regulation. Conclusions: Based on our findings, we emphasize conceptualization of PUD as an Attachment Disorder, on a behavioral as well as on a neural level. Furthermore, we point out the importance of an integrated bio-psycho-social approach in this research area. Consequently, future studies might more closely focus on the influence of attachment-based interventions on emotion regulation abilities as well as a potentially related neuroplasticity. Neuroplastic changes, which are still rather unexplored, might represent important parameters for the assessment of treatment outcomes especially in long-term SUD treatment.

[Addiction as an attachment disorder]

BACKGROUND

There is no commonly accepted model for describing the development and treatment of substance use disorders (SUD); however, over several decades the attachment theory has represented an important basis for the clinical handling of SUD. This study gives a systematic review of empirical studies regarding the relationship between SUD and disorders of attachment behavior.

OBJECTIVE

Is there a positive relationship between disorders of attachment behavior and the presence of SUD?

METHOD

Various databases (PsychInfo, Web of Science, PubMed) were systematically searched in order to pinpoint relevant studies in books and articles published in English or German. Based on the results 22 publications were selected. After a stricter limitation to original research, 12 articles could finally be accepted as eligible.

RESULTS

A significant relationship was found between SUD and insecure attachment in 10 out of the 12 studies.

CONCLUSION

Based on the results of the research studies reviewed the hypothesis to characterize SUD as a possible expression of an attachment disorder was confirmed. This corroborates the importance of considering attachment parameters in dealing with prevention and treatment of SUD. Further research might focus on non-substance-related addictive disorders and therapy outcome studies.

Frustration Tolerance and Personality Traits in Patients With Substance Use Disorders

Previous research has suggested the prevalence of certain personality traits, some of which are related to a disorganized attachment, in substance abuse disorders. Further, frustration tolerance (FT) has been proposed as an important factor in addiction, both at the inception-following the "self-medication" hypothesis-and regarding treatment compliance. In turn, an inadequate response to frustrating events has been also associated with a disrupted attachment. Our goal is to explore the mediational role of FT in the relationship between personality traits and two different treatments for substance addiction: therapeutic community (TC) and ambulatory treatment (AT). Eighty-four subjects with substance abuse disorder were recruited in total (22 female), including 46 volunteers (13 female) in TC and 38 (9 female) in AT. They were assessed with Rosenzweig's test for FT and the Millon Clinical Multiaxial Inventory-III (MCMI-III) test to evaluate personality factors. By comparing with a control sample (335 volunteers, 268 female), we found that FT was lower in patients. Between therapeutic groups, FT was significantly lower in TC. Depressive, antisocial, sadistic, negativistic, schizotypal, borderline, paranoid, anxiety, dysthymia, alcohol use, drug use, posttraumatic stress disorder (PTSD), thought disorder, and delusional disorder traits were suggestive of pathology in the clinical samples and were significantly different between control, AT, and TC groups. Further, anxiety and PTSD traits were higher in TC than in AT. A mediational analysis revealed that the effect of anxiety and PTSD scales on therapeutic group was partially mediated by FT. In conclusion, FT and its interplay with personality traits commonly related to disorganized attachment (anxiety and PTSD) might be important factors to consider within therapeutic programs for persons with substance addiction.

Attachment and Substance Use Disorders-Theoretical Models, Empirical Evidence, and Implications for Treatment

Introduction: The article reviews attachment-oriented research in individuals with substance use disorders (SUDs). Based on attachment theory, substance abuse can be understood as "self-medication," as an attempt to compensate for lacking attachment strategies. Attachment theory suggests a developmental pathway from insecure attachment to SUD and, on the other hand, a negative impact of substance abuse on attachment security. Earlier reviews have indicated a general link but have been inconclusive with regard to other aspects. In the light of a growing body of research, this review is looking for evidence for the general link, for its direction, for differences due to different patterns of attachment, different substances and severities, comorbid psychiatric disorders, and age groups. Methods: Using medical and psychological databases, 34 cross-sectional studies, three longitudinal studies, and a systematic meta-analysis were identified. Methodological problems such as poor assessment of SUD and the use of different measures of attachment limit comparability. Results: All cross-sectional studies in the review confirm a link between insecure attachment and SUD. Results of longitudinal studies show insecure attachment to be a risk factor for SUD, while continued substance abuse impairs the ability to form close relationships. With regard to specific patterns of attachment, results mainly point toward very insecure patterns. They indicate different patterns of attachment in different groups of substance abusers, suggesting different developmental pathways. Fearful-avoidant attachment was frequent in heroin addicts, while alcohol abusers displayed more heterogeneous patterns. Comorbid mental disorders and severity of SUD seem to be important factors, but data are still inconclusive. The link between insecure attachment and SUD seems to be stronger in adolescence compared to adulthood. Discussion: The last decades have seen a substantial growth in studies on attachment and SUDs. Despite methodological problems, the general link between insecure attachment and SUD today is well established. Attachment theory might contribute to the understanding and treatment of SUDs in a significant way. But to do so, a lot of open questions have to be answered. We will need more carefully designed longitudinal studies, more studies connecting psychological data with brain processes, and more clinical trials.

Anxiety-Related Coping Styles, Social Support, and Internet Use Disorder

Objective: The Internet can offer a seemingly safe haven for those being disappointed by relationships in the "offline world". Although the Internet can provide lonely people with opportunities to seek for help and support online, complete withdrawal from the offline world comes with costs. It is discussed if people can even become "addicted" to the Internet. Of note, meanwhile, many researchers prefer the term Internet use disorder (IUD) instead of using the term "Internet addiction". To illustrate the importance of one's own social network supporting a person in everyday life, we investigated, for the first time to our knowledge, how social resources in terms of quality and quantity might represent a buffer against the development of IUD. Furthermore, anxiety related coping styles are investigated as a further independent variable likely impacting on the development of an IUD. Method: In the present work, N = 567 participants (n = 164 males and n = 403 females; M_age = 23.236; SD_age = 8.334) filled in a personality questionnaire assessing individual differences in cognitive avoidant and vigilant anxiety processing, ergo, traits describing individual differences in everyday coping styles/modes. Moreover, all participants provided information on individual differences in tendencies toward IUD, the perceived quality of social support received, and the size of their social network (hence a quantity measure). Results: Participants with larger social networks and higher scores in the received social support reported the lowest tendencies toward IUD in our data. A vigilant coping style was positively correlated with tendencies toward IUD, whereas no robust associations could be observed between a cognitive avoidant coping style and tendencies toward IUD. Hierarchical linear regression underlined an important predictive role of the interaction term of vigilance in ego-threat scenarios and perceived quality of social support. Conclusion: The current study not only yields support for the hypothesis that the size of one's own social network as well as the perceived quality of social support received in everyday life present putative resilience factors against developing IUD. It also supports the approach that special coping styles are needed to make use of the social support offered.

The Influence of Attachment Styles and Personality Organization on Emotional Functioning After Childhood Trauma

Background: Current literature suggests a tenuous link among childhood trauma, personality organization, adult attachment, and emotional functioning in various psychiatric disorders. However, empirical research focusing on the interaction of these concepts is sparse. Therefore, this study intends to investigate the influence of personality organization and attachment dimensions on the relationship between childhood maltreatment and emotional functioning in adult life. To assess emotional functioning, we adopted the Affective Neuroscience model of primary emotions, comprising SEEKING, FEAR, ANGER, SADNESS, CARE, and PLAY. Methods: The total sample consisted of 616 nonclinical adults (Age: M = 30; SD = 9.53; 61.9% female). Path analysis was applied to investigate interactions among childhood trauma, personality organization, adult attachment, and primary emotion dispositions. Results: The findings suggest that childhood trauma significantly predicted deficits in personality organization and insecure attachment (all p < 0.001). Furthermore, a reduced level of personality organization was significantly associated with increased ANGER (p < 0.001), whereas adult attachment substantially predicted primary emotion dispositions in general. Moreover, the results indicate significant mediational effects of personality organization and attachment dimensions on the relationship between childhood trauma and primary emotions (p < 0.01). The final model was able to explain 48% of the variance in SADNESS, 38% in PLAY, 35% in FEAR, 28% in CARE, 14% in ANGER, and 13% in SEEKING. Discussion: The findings contribute to the understanding of the relationship between childhood maltreatment and impaired emotional functioning in adult life. Furthermore, the importance of personality organization and attachment dimensions for emotion regulation is underlined. Consequently, the treatment of patients with childhood trauma should focus on facilitating the development of more secure attachment patterns and increased personality functioning to improve overall emotional functioning.

Comparison of Students With and Without Problematic Smartphone Use in Light of Attachment Style

Background: Nowadays, media addictions are especially of high relevance to psychotherapeutic practice. More recently, this particularly includes excessive smartphone usage. Even though a growing number of scientific literature and also mainstream media highlight problematic smartphone use as a serious health problem, there is only little research on this issue. Objective: The aim of this study was to examine this phenomenon with a focus on attachment-specific differences between students with and without problematic smartphone use. Method: A survey was carried out on all enrolled students of the Sigmund Freud University Vienna. The Smartphone Addiction Scale (SPAS) was used to differentiate between students with and without problematic smartphone use. The attachment style was assessed using the Bielefeld Partnership Expectations Questionnaire (BFPE). Results: Of the total sample, 75 of the students (15.1%) showed a problematic smartphone use. A positive correlation between excessive smartphone usage and an insecure attachment style was found. Discussion: Therapy for problematic smartphone use should be carried out in light of patient's attachment style. Further research into other factors of mental stress and personality is needed to better understand problematic smartphone use.

Do Primary Emotions Predict Psychopathological Symptoms? A Multigroup Path Analysis

Background: Research involving animal models has repeatedly proposed dysregulations in subcortically rooted affective systems as a crucial etiological factor in the development of a variety of psychiatric disorders. However, empirical studies with human participants testing these hypotheses have been sparse. Associations between primary emotions systems and different psychiatric symptoms were investigated in order to gain insights into the influence of evolutionary-rooted primary emotions on psychopathology. Material and Methods: The community sample included 616 adults (61.9% female). 243 reported a psychiatric lifetime diagnosis. By applying path analysis, we estimated paths between SEEKING, ANGER, FEAR, SADNESS, CARE, and PLAY (Affective Neuroscience Personality Scales; ANPS) and symptoms of substance abuse (Alcohol, Smoking, and Substance Involvement Screening Test; ASSIST) as well as depression, anxiety, and somatization (Brief Symptom Inventory; BSI-18). To examine the moderator effects of gender and psychiatric lifetime diagnosis, multigroup analysis was applied. Results: Substance abuse was associated with male sex (β = -.25), SADNESS (β = .25), and ANGER (β = .10). Depression was associated with SADNESS (β = .53), FEAR (β = .10), SEEKING (β = -.10), and PLAY (β = -.15). Anxiety was linked to SADNESS (β = .33), FEAR (β = .21) and PLAY (β = -.10). Somatization was associated with SADNESS (β = .26) and PLAY (β = -.12; all p < .001). Multigroup analysis revealed no differences in paths between tested groups (all p > .01). The model explained 14% of the variance of substance abuse, 52% of depression, 32% of anxiety, and 14% of somatization. Conclusions: The results further our understanding of the differential role of primary emotions in the development of psychopathology. In this, the general assumption that primary emotion functioning might be a valuable target in mental health care is underlined.

Addiction, Stress, and Relational Disorder: A Neuro-Informed Approach to Intervention

Substance use disorders are immensely costly economically and socially, but also in relational terms. The helping fields have struggled to arrive at consensus about substance use disorders and to endorse effective treatment approaches. We suggest that counselors will find it useful to frame substance use disorders as a type of relational disorder, a cycle wherein early nurturance disruption leads to brain function vulnerability and subsequent interpersonal difficulty. This difficulty in establishing and maintaining connections with others, in turn, can lead to susceptibility to substance use disorders. This article discusses basic neurophysiology surrounding substance use and relational disorders that can be used to inform efficacious counseling approaches for working with individuals facing substance use disorders. Such approaches explore the connection between substance use and relational disorders in terms of long-term exposure to nonnurturing environments. Our hope is that conceptualizing substance use disorders as relational disorder will assist clinicians in building more informed conceptualizations of their clients and reconsidering how they may work to rebuild this relational capacity, drawing on the brain's adaptive nature and potential for healing.

Personality Influences the Relationship Between Primary Emotions and Religious/Spiritual Well-Being

The study of human emotions and personality provides valuable insights into the parameters of mental health and well-being. Affective neuroscience proposes that several levels of emotions - ranging from primary ones such as LUST or FEAR up to higher emotions such as spirituality - interact on a neural level. The present study aimed to further explore this theory. Furthermore, we hypothesized that personality - formed by bottom-up primary emotions and cortical top-down regulation - might act as a link between primary emotions and religious/spiritual well-being. A total sample of 167 (78% female) student participants completed the Affective Neuroscience Personality Scale (primary emotions), the Big Five Personality Inventory and the Multidimensional Inventory of Religious/Spiritual Well-Being (higher emotions). Correlation analyses confirmed the link between primary and higher emotions as well as their relation to personality. Further regression analyses indicated that personality dimensions mediate the relationship between primary and higher emotions. A substantial interaction between primary emotions, personality dimensions, and religious/spiritual well-being could be confirmed. From a developmental perspective, cortical top-down regulation might influence religious/spiritual well-being by forming relevant personality dimensions. Hence, CARE as well as Agreeableness seem of special importance. Future studies might focus on implications for clinical groups.

Increased attachment security is related to early therapy drop-out in substance use disorders

OBJECTIVES

Previous research work suggests a positive association between secure attachment and increased therapy adherence (TA) in different patient groups. However, there is still a strong need for research focusing on the influence of attachment on TA in substance use disorder (SUD) treatment. Hence, this study attempts to investigate the predictive value of different attachment patterns concerning TA in SUD inpatients.

RESULTS

122 (34 female) SUD inpatients completed the Attachment Style Questionnaire (ASQ) during the entry phase of therapeutic community treatment. After 6 weeks, subjects who remained in therapy (n = 47) completed the ASQ for a second time. In line with the literature, agglomerative Cluster Analysis suggested a two-cluster solution (Cluster I: increased secure attachment pattern; Cluster II: increased insecure attachment pattern). Notably, inpatients in Cluster I were more likely to drop out of treatment within the first 6 weeks (p < .001). Furthermore, subjects showed less "Confidence in Self and Others" (p < .05) after 6 weeks of treatment. Our findings indicate a negative predictive value of increased attachment security for TA in SUD inpatients. This finding probably mirrors a more realistic kind of self-assessment. More generally, the importance of considering attachment styles in SUD treatment is underlined.

Depressive Symptoms and Addictive Behaviors in Young Adults After Childhood Trauma: The Mediating Role of Personality Organization and Despair

Background: There is substantial evidence that traumatic experiences in childhood increase the likelihood of mood pathology and addictive behaviors in adolescence and young adulthood. Furthermore, both forms of psychopathology have been linked to deficiencies in personality organization and a common primary emotion core. In this study, we intended to further investigate these interactions by assuming a mediating role of personality organization and despair regarding the relationship between childhood trauma and psychiatric symptom burden later in life. Methods: A total sample of 500 young adults (Age: M = 26; SD = 5.51; 63.2% female) were investigated. Structural Equation Modeling was applied in order to investigate the pathways between the latent variables Childhood Trauma, Structural Deficit, Despair (comprised of the primary emotions SEEKING and SADNESS), as well as symptoms of addiction and depression. Results: The results indicate that the influence of Childhood Trauma on Addictive Behaviors was mediated by Structural Deficit (p < 0.01), whereas its influence on Depressive Symptoms was mediated by Despair (decreased SEEKING and increased SADNESS) (p < 0.01). Furthermore, Addictive Behaviors seemed to be stronger represented in males (p < 0.001). The final model was able to explain 39% of the variance of Addictive Behaviors and 85% of the variance of Depressive Symptoms. Discussion: The findings underline the importance of early experiences in the development of adult affective and personality functioning, which is linked to the development of psychiatric disorders. Regarding clinical practice, addiction treatment might focus on the improvement of personality organization, while treatment of depressed patients should primarily emphasize the restructuring of dysfunctional primary emotion dispositions.