Pain sensitivity, negative affect, and alcohol use disorder status: A moderated mediation study of emotion dysregulation

Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study inves-tigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD

Substance use disorder status moderates the association between personality traits and problematic mobile phone/internet use

Background: Associations between personality traits and problematic smartphone use (PSU) among individuals with substance use disorder (SUD) have not been widely investigated. The current study aims to assess whether SUD status moderates the association between personality traits and PSU. Methods: The study group included 151 individuals with SUD and a normative sample (NS) comprised of 554 non-SUD students. The following self-report questionnaires were used: the Mobile Phone Problem Use Scale (MPPUS-10) to assess problematic smartphone use (PSU), the Internet Addiction Test (IAT) to assess intensity of internet use, and the NEO Five-Factor Inventory (NEO-FFI) to assess Personality traits. Results: SUD status moderated the association between neuroticism and openness to new experiences on PSU. That is, greater neuroticism and openness were significantly associated with more excessive PSU among the NS. In the SUD group, greater openness was a significant protective factor against PSU. Moderation results were similar when using the IAT (which was significantly correlated with MPPUS) as an outcome. Conclusions: The presence of SUD may influence how personality traits are associated with problematic mobile phone/internet use. Given that this is among one of the first studies examining this topic, findings should be replicated with additional studies

Interoception, alexithymia, and anxiety among individuals with alcohol use disorder

BackgroundInteroception (i.e., the ability to recognize bodily signals), alexithymia (i.e., the inability to recognize emotional states) and negative affect (i.e., unpleasant feelings such as anxiety) have been associated with alcohol use disorder (AUD). Previous research suggests that interoception may underlie alexithymia, which in turn may be associated with negative affectivity. However, this remains to be empirically tested. This study investigates whether alexithymia mediates the association between interoception and anxiety and whether this association differs across individuals with AUD and a healthy control (HC) comparison group.MethodsThe AUD group consisted of 99 participants enrolled in an 8-week abstinence-based inpatient treatment program. The HC group included 103 healthy individuals. The heartbeat counting task (HCT) was used to assess interoception (cardiac interoceptive accuracy). The Toronto Alexithymia Scale (TAS-20) was used to assess alexithymia. The Brief Symptom Inventory (BSI) was used to assess anxiety.ResultsThe moderated mediation model with interoception as the predictor, alexithymia as the mediator, and negative affect (i.e., state anxiety) as the dependent variable was tested. The analysis showed that the conditional indirect effect of interoception on anxiety via alexithymia was significant for individuals with AUD [ab = −0.300, bootstrap 95% CI = (−0.618, −0.088)], as well as for HCs [ab = −0.088, bootstrap 95% CI = (−0.195, −0.014)]; however, the conditional indirect effect significantly differed across HCs and individuals with AUD. Namely, the mediated effect was greater among individuals with AUD compared to the HC group.ConclusionThe results suggests that interoceptive impairment contributes to greater negative affect (i.e., state anxiety) via alexithymia especially for individuals with AUD. Improving emotion recognition via therapeutic methods focused on strengthening interoceptive abilities could improve outcomes for individuals receiving treatment for AUD

Molestowanie seksualne przed uzyskaniem pełnoletności a stan zdrowia i funkcjonowanie społeczne osób uzależnionych od opioidów leczonych substytucyjnie

Introduction: A number of previous studies confirmed worse health and social conditions among opioid-dependent individuals with a childhood history of sexual abuse. To the best of our knowledge, this issue has not been investigated in the Polish population. We aimed to analyse the prevalence of sexual abuse in opioid-dependent individuals undergoing therapy in the methadone maintenance clinic and to assess the association of clinical and social characteristics with a history of sexual abuse. Method: The study included a sample of 240 opioid-dependent patients. Participants were interviewed using self-reported questionnaire and standardised measures on experience of childhood and adulthood abuse, physical and mental health, addictions, social functioning and family history. Results: About 35% of women reported sexual violence in childhood. Sexual abuse in this period was associated with family dysfunction, physical abuse, current more intensive depressive symptoms and pain, as well as suicide attempts with stronger morbid desires. Discussion: The present findings are consistent with previous research of other authors. Interestingly, the present study did not confirm the relationship between sexual abuse and severity of opioid or alcohol dependence and poor social functioning. Conclusion: The results of our study suggest the potential benefit to multifaceted treatment approach, which should specifically address sexual abuse and suicidal behaviour in opioid-dependent patients

Emotion regulation in binge eating disorder.

A review of the literature on emotion regulation in binge eating disorder (BED) published both in English and Polish between 1990 and 2020. BED might be considered as an impulsive and compulsive disorder associated with altered reward sensitivity and food-related attentional bias. The growing body of research indicated that there were corticostriatal circuitry alterations in BED, comparable to those observed in substance abuse, including altered function of orbitofrontal, prefrontal and insular cortices with the striatum included. Negative emotions and deficits in their regulation play a significant role in BED. Processing of anger, anxiety and sadness appear to be particularly important in this disorder. Research results identified an increase in negative emotions preceding episodes of binge eating. However, there is still inconsistency when it comes to whether these episodes alleviate negative affect. Individuals with BED more often use non-adaptive emotion regulation strategies, such as rumination and suppression of negative sensations. Whereas adaptive ones, for instance, cognitive reappraisal, are used less often. Clinical implications, besides pharmacology, highlight the high effectiveness of enhanced cognitive behavioral therapy (CBT-E), dialectic-behavioral therapy (DBT) and psychodynamic therapy in the treatment of emotional dysregulation in BED. Further studies, including ecological momentary assessment (EMA), should focus on emotional changes related to the binge cycle and the identification of reinforcing factors of BED

Alcohol use and interoception - A narrative review.

Interoception, defined as the ability to perceive and interpret body signals, may play an important role in alcohol use disorder (AUD). Earlier studies suggested an association between interoception impairment and known risk factors for AUD (e.g., alexithymia, emotion dysregulation, impulsivity, pain). Neurobiological studies show that the neurotoxicity of alcohol affects various elements of the interoceptive system (especially the insula) at structural and functional levels, with differential short/long term impacts. Conversely, primary interoceptive impairments may promote alcohol consumption and foster the evolution towards addiction. Despite convincing evidence demonstrating that interoception impairment may be an important contributor to the development and course of AUD, only a few studies directly evaluated interoceptive abilities in AUD. The research shows that interoceptive accuracy, the objective component of interoception, is lower in AUD individuals, and is correlated with craving and emotion dysregulation. Interoceptive sensibility is in turn higher in AUD individuals compared to healthy controls. Moreover, there is evidence that therapy focused on improving the ability to sense signals from the body in addiction treatment is effective. However, important methodological limitations in interoceptive measures persist, and it is therefore necessary to further investigate the associations between interoception and AUD

Czynniki ryzyka podejmowania prób samobójczych u osób leczonych stacjonarnie z powodu uzależnienia od alkoholu w Polsce

Introduction: Alcohol dependence is an important risk factor for suicidal behaviours. Current data show that between 14 and 43% of alcohol-dependent patients attempt suicide. The aim of the present study was to analyse the risk factors for suicide attempts among patients treated for alcohol dependence. Methods: Medical data of 994 patients hospitalised in Alcohol Detoxification and Rehabilitation Units of Nowowiejski Hospital in Warsaw were analysed. The relationships between variables that are thought to be related to the prevalence of suicide attempts in this population were evaluated. The relevant psycho-social and demographic data as well as information on alcohol use and treatment history were included. Results: 292 (29%) patients confirmed suicide attempts in the past. Among the variables included in the logistic regression model, previous episodes of delirium tremens, earlier onset of alcohol dependence, comorbidity of somatic disorders, and unemployment proved to be significant risk factors for previous suicide attempts. Discussion: The higher prevalence of suicide attempts among patients with previous episodes of delirium tremens and earlier onset of alcohol dependence confirms the relationship between the severity of alcohol dependence and suicide attempts. The effect of unemployment and comorbidity of somatic disorders on incidence of suicide attempts might presumably be mediated by co-occurring pain, depression, and poorer social functioning. Conclusions: Earlier onset of alcohol dependence and previous episodes of delirium tremens are the risk factors of suicide attempts attributable to the severity of alcohol dependence. The other risk factors (unemployment and somatic disorders) are nonspecific to alcohol dependence, and were previously found to increase the risk in various psychiatric populations

Pain Sensitivity, Negative Affect, and Alcohol Use Disorder Status: A Moderated Mediation Study of Emotion Dysregulation

Previous work suggests that the association between pain and emotional processes among individuals with alcohol use disorder (AUD) may differ from healthy controls. This study investigates whether pain sensitivity mediates the association between negative affect and emotional dysregulation and whether this association differs across AUD status using moderated mediation. The sample included 165 individuals diagnosed with AUD and 110 healthy controls. Of interest was pain sensitivity, as assessed with the Pain Sensitivity Questionnaire, negative affect, as assessed with the Beck Depression Inventory, and emotional dysregulation, as assessed with the Difficulties in Emotional regulation Scale. Age, biological sex, and current pain severity were included as covariates. The results support a moderated partial mediation model that explained 44% of the variance in emotional dysregulation. The findings indicate that negative affect is related to higher pain sensitivity across groups. Moreover, pain sensitivity partially mediated the association between negative affect and emotional dysregulation, but in opposite directions depending on AUD status. Among healthy controls, greater pain sensitivity was related to better emotional regulation, while greater pain sensitivity led to greater emotional dysregulation among individuals with AUD. The potential parallels in the underlying neurobiological mechanisms of emotionality, pain, and AUD suggest that interventions targeting pain may improve adaptive affect regulation skills, which in turn could reduce negative affect and its effect on pain sensitivity among individuals with AUD