Chemical Reactions: Marijuana, Opioids, and Our Families

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families

Envisioning a future: Values clarification in early recovery from opioid use disorder

High rates of relapse and overdose during early recovery from opioid use disorder (OUD) highlight the importance of providing effective treatment during this crucial phase. While early treatment often focuses on managing urges and withdrawal symptoms, eliciting personally salient motivators may help to target predictors of treatment outcomes such as motivation and self-efficacy. This experimental study examined the effect of a brief values clarification exercise on motivation and self-efficacy for abstinence in a sample of n = 93 individuals in brief residential treatment for OUD. Participants were randomly assigned to values clarification or a time management control condition exercise. Self-efficacy for abstinence as measured by a validated single-item measure was higher for participants in the values condition (M = 8.7) compared to control (M = 7.8, p = .013), while motivation for abstinence as measured by the commitment to sobriety scale was similarly high for both the values clarification (M = 28.0) and control (M = 27.8, p = .642) groups. There were no group differences in delay discounting, the theorized mediator of these relationships. Taken together, these results suggest that even a brief values clarification exercise may increase self-efficacy for abstinence when added to early residential treatment for OUD

The integrated constructionist approach to emotions: A theoretical model for explaining alterations to positive emotional experiences in the aftermath of trauma

Prior research has assumed that individuals with PTSD find positive emotions enjoyable and rewarding. While intuitive, this assumption is problematic for a number of reasons. A growing body of literature suggests that positive emotions can be unwanted and uncomfortable experiences for many people, particularly individuals with PTSD. Yet our empirical and theoretical models of PTSD do not adequately account for this complexity. Throughout the following pages, we argue that the same behavioral processes that have been heavily researched and associated with fear and avoidance of negative emotions and PTSD can be extended to positive emotions as well. We propose the integrated constructionist approach to emotions, which integrates learning theory principles with a constructionist approach and suggest that trauma experiences lead to a shift in the evaluation, interpretation, and labeling of an individual\u27s internal experiences. This evaluative shift results in generalized patterns of emotional responding characterized by efforts to downregulate internal stimuli that were previously defined as positive and may have been appetitive pre-trauma. We subsequently highlight the theoretical, empirical, and clinical importance of taking an idiographic approach to understanding and working with emotions among individuals with PTSD

Predicting Improvement After a Bystander Program for the Prevention of Sexual and Dating Violence

Although evidence suggests that bystander prevention programs are promising interventions for decreasing sexual violence and dating violence on college campuses, there have been no studies to date evaluating moderators of bystander program effectiveness. The current study evaluates whether different demographic characteristics, attitudes, knowledge, and behaviors at pretest predict change over a 6-month follow-up for students who participated in a bystander prevention program. Participants in the three assessments (pretest, posttest, 6-month follow-up) included 296 college students who were mandated to attend a bystander program during their first year orientation. Analyses showed that with few exceptions, the bystander program worked best for students who were most at risk given their pretest demographics and levels of attitudes condoning dating violence and sexual violence, bystander efficacy, and bystander behaviors. Results are discussed in terms of suggestions for future research

Betrayal vs. nonbetrayal trauma: Examining the different effects of social support and emotion regulation on PTSD symptom severity.

Objective: Betrayal Trauma Theory posits that interpersonal traumas are particularly injurious when the perpetrator is a person that the victim previously trusted and was close to. A relevant protective factor to examine is social support, which may influence PTSD symptomology through its influence on emotion regulation. The aim of the current study was to examine differences in the associations between social support, emotion regulation, and PTSD symptom severity for survivors of betrayal trauma and nonbetrayal trauma. Method: Two hundred and 73 trauma survivors (age: M = 25.96 years, SD = 9.42 years; 80.2% female; 63.7% White) completed the anonymous, online survey. Results: Across both groups, emotion regulation mediated the relationship between social support and PTSD symptom severity. A multiple-samples SEM analysis showed that the betrayal group evidenced a weaker relationship between social support and emotion regulation. Conclusions: Findings suggest that survivors of high betrayal trauma may not engage with their social support in ways that foster emotion regulation skills. Therefore, for high betrayal trauma survivors specifically, group interventions that involve the survivor and close contact(s), may be particularly beneficial in enhancing emotion regulation and decreasing PTSD symptomology. (PsycInfo Database Record (c) 2020 APA, all rights reserved

Transitional stress influences problem alcohol use and emotion regulation in late adolescence: A mixed-methods study

Rates of alcohol use peak during the transition from adolescence to young adulthood, a developmental phase that encompasses heightened stress and emotion regulation demands. This mixed methods study examines the influence of a critical developmental transition, high school graduation, on the relationship between problem alcohol use and emotion regulation. High school seniors (N = 117) were surveyed within three months of graduation. Quantitative analyses show that transition stress, but not emotion regulation, predicts alcohol-related problems. Qualitative analyses reveal that adolescent high-risk drinkers engage in a variety of strategies to regulate distress. Implications for adolescent substance misuse prevention programs are discussed

Beyond symptom severity: The differential impact of distress tolerance and reward responsiveness on quality of life in depressed and non-depressed individuals

Economic and patient-centered research highlights the role of quality of life outcomes above and beyond symptom severity as a key target of depression treatment. Thus, research investigating processes related to the etiology and treatment of depression needs to consider such outcomes in addition to symptom-specific measures. The current study evaluated two such processes, derived from operant conditioning principles of reinforcement: distress tolerance (DT) and reward responsiveness (RR). We examined the direct effects of these processes on quality of life in a sample of depressed (n = 34) and non-depressed (n = 33) participants, and conducted an exploratory analysis of their potential interaction. Results indicated that higher levels of RR and DT were associated with higher overall quality of life regardless of diagnostic status. We did not find the expected interaction between DT and RR, though results indicate a potential trend suggesting DT may provide a protective influence for individuals with low RR. Results highlight the importance of both tolerating distress and responding to rewards for individuals along the quality of life continuum. While this investigation focused on the highly heterogeneous diagnosis of depression, future investigations should extend such work to consider mixed diagnostic samples to further enhance the validity of such processes as potential treatment targets in real-world clinical settings

An Analysis of help-seeking patterns among college student victims of sexual assault, dating violence, and stalking

Despite the negative outcomes associated with sexual assault (SA), dating violence (DV), and stalking victimization, many victims, particularly college students, do not seek help for these crimes. To date, the majority of help-seeking research has focused on one form of victimization, despite substantial evidence that many victims experience more than one form of interpersonal violence. In addition to consideration of such polyvictims, intervention efforts to increase help-seeking to improve victim outcomes may benefit from a clearer understanding of overlapping predictors of help-seeking across victimization types. Using the health belief model (HBM) as a guiding framework, the current study examined predictors of help-seeking for SA, DV, and stalking in a college student sample. Data were collected via a multiyear anonymous email survey of general health and well-being. Demographic predictors of help-seeking and severity indicators informed by the HBM were evaluated across violence types. In addition to replicating previous work, results provided support for the HBM, such that a number of severity indicators, particularly those representing overlap across victimization types, predicted help-seeking at the multivariate level. Results also provide new evidence for overlap of barriers to help-seeking across violence types, with victim’s belief that the incident was not serious enough the most commonly reported reason for not seeking help across all three types of victimization. This overlap may provide opportunities for consolidating prevention and intervention efforts across victimization types

Differential gender responses to an empathy component of a sexual assault prevention program

Although sexual assault (SA) prevention programs on college campuses are increasingly prevalent, no studies explore the influence of program components on outcomes. Empathy exercises are frequently included in such programs, with the intent of changing participant emotions and attitudes in order to change subsequent behavior. This study evaluated whether the inclusion of an empathy exercise within a SA prevention program impacted participants’ emotions and attitudes, and subsequent helping behaviors in SA bystander situations. Three-hundred and seventy students (63% women) participated in an evaluation of a mandatory bystander intervention program; half the students received the program containing an empathy exercise and half received the program that did not. For women only, participation in the program with the empathy exercise led to more negative emotions and fewer attitudes condoning SA, the latter of which influenced greater prosocial bystander behaviors 6 months later

A contextual behavior science framework for understanding how behavioral flexibility relates to anxiety

There is a growing literature focusing on the emerging idea that behavioral flexibility, rather than particular emotion regulation strategies per se, provides greater promise in predicting and influencing anxiety-related psychopathology. Yet this line of research and theoretical analysis appear to be plagued by its own challenges. For example, middle-level constructs, such as behavioral flexibility, are difficult to define, difficult to measure, and difficult to interpret in relation to clinical interventions. A key point that some researchers have made is that previous studies examining flexible use of emotion regulation strategies (or, more broadly, coping) have failed due to a lack of focus on context. That is, examining strategies in isolation of the context in which they are used provides limited information on the suitability, rigid adherence, or effectiveness of a given strategy in that situation. Several of these researchers have proposed the development of new models to define and measure various types of behavioral flexibility. We would like to suggest that an explanation of the phenomenon already exists and that we can go back to our behavioral roots to understand this phenomenon rather than focusing on defining and capturing a new process. Indeed, thorough contextual behavioral analyses already yield a useful account of what has been observed. We will articulate a model explaining behavioral flexibility using a functional, contextual framework, with anxiety-related disorders as an example