Anxiety disorders moderate the association between externalizing problems and substance use disorders: Data from the National Comorbidity Survey-Revised

Item does not contain fulltextAnxiety disorders and externalizing problems are both associated with substance use disorders. However, the nature of this relationship remains unclear. To examine whether presence of an anxiety disorder changes the association between externalizing problems (conduct disorder, oppositional defiant disorder, and attention deficit hyperactivity disorder) and substance use disorders, we analyzed data from the National Comorbidity Survey-Replication, which is based on a nationally representative sample of 9282 English-speaking adults. Presence of externalizing problems was associated with an increased odds for alcohol abuse (OR: 6.7, CI: 5.6-8.1), alcohol dependence (OR: 7.6, CI: 5.9-9.6), substance abuse (OR: 9.9. CI: 8.1-12.2), and substance dependence (OR: 13.1. CI: 9.6-17.8). Similarly, anxiety disorders were associated with increased odds for substance use disorders. The highest association was found between post-traumatic stress disorder and substance use disorder (OR: 9.2, CI: 5.4-15.5). Individuals who met diagnostic criteria for an anxiety disorder and externalizing problems showed consistently and significantly lower odds for substance use problems than subjects with externalizing problems without a comorbid anxiety disorder. The results suggest that presence of any anxiety disorder reduces the association between externalizing problems and substance use disorders, possibly because the fear of bodily symptoms prevents individuals with externalizing problems from engaging in drug-seeking behaviors

When social anxiety disorder co-exists with risk-prone, approach behavior: Investigating a neglected, meaningful subset of people in the National Comorbidity Survey-Replication

Item does not contain fulltextLittle is known about people with social anxiety disorder (SAD) who are not behaviorally inhibited. To advance knowledge on phenomenology, functional impairment, and treatment seeking, we investigated whether engaging in risk-prone behaviors accounts for heterogeneous outcomes in people with SAD. Using the National Comorbidity Survey-Replication (NCS-R) dataset, our analyses focused on people with current (N = 679) or lifetime (N = 1143) SAD diagnoses. Using latent class analysis on NCS-R risk-prone behavior items, results supported two SAD classes: (1) a pattern of behavioral inhibition and risk aversion and (2) an atypical pattern of high anger and aggression, and moderate/high sexual impulsivity and substance use problems. An atypical pattern of risk-prone behaviors was associated with greater functional impairment, less education and income, younger age, and particular psychiatric comorbidities. Results could not be subsumed by the severity, type, or number of social fears, or comorbid anxiety or mood disorders. Conclusions about the nature, course, and treatment of SAD may be compromised by not attending to heterogeneity in behavior patterns

Capitalizing on the success of romantic partners:A laboratory investigation on subjective, facial, and physiological emotional processing

Receiving a constructive, supportive response from romantic partners after sharing good news has been shown to magnify the positivity of events and predict healthy relationship outcomes. We conducted a laboratory social interaction to determine whether supportive responses to success led to changes in facial expressions, sympathetic arousal, and felt emotions. Our methodology allowed us to break down the sequence of capitalization support. In 69 romantic couples, we recorded emotional processing before, during, and after the task in both partners. Person A received performance feedback on a computer task and shared their success via text messages with Person B, who then reacted to this success. Supportive capitalization responses led to greater felt positive emotions and a trend for fewer negative emotions; effects were similar for givers and receivers of supportive responses. Facial expressions were also happier for people receiving supportive capitalization responses. Results suggest the importance of addressing the giving and receiving of capitalization support within the same social situation. Keywords: Romantic couples, Capitalization, Facial expression, Positive emotion, Physiolog

A brief educational intervention using acceptance and commitment therapy: Four injured athletes' experiences

The purpose of this study was to research the experiences of four injured athletes during their rehabilitation from ACL injuries and to examine the potential usefulness of an adapted ACT intervention in addressing individuals' adherence to rehabilitation protocols and their general psychological well-being. We investigated the usefulness of a brief, 4-session ACT program adapted for educational purposes and presented data as case studies. The case studies suggested that (a) the injured athletes experienced a multitude of private events immediately following injury, throughout their recovery, and when approaching a full return to sport; (b) the injured athletes typically avoided these private events and engaged in emotion-driven behaviors; (c) an adapted ACT approach for educational purposes could be useful on at least a basic level to help injured athletes accept private events, commit to rehabilitation behaviors, and have some certainty about returning to sport; and (d) more could be done to address the needs of injured athletes beyond the structure of our 4-session educational intervention. We concluded that the ACT-based intervention, to a certain extent, educated injured athletes about how to meet the challenges of their recoveries and how to commit to their rehabilitations, as well as to exhibit behaviors that would potentially permit their successful reentries to sport