The prevalence of substance use disorders and psychiatric disorders as a function of psychotic symptoms

Psychotic symptoms represent one of the most severe and functionally impairing components of several psychological disorders. One group with particularly high rates of psychotic symptoms is chronic substance users. However, the literature on psychotic symptoms and substance use is quite narrow and has focused almost exclusively on drug-induced psychosis, neglecting the population of substance users with psychotic symptoms occurring independently of acute drug effects

An Ecological Systems Approach to Understanding Intimate Partner Violence Outcomes

The present study examined the influence of person-level, event-level, geographic, and social factors on the maintenance of mental health conditions in women survivors of intimate partner violence (IPV). The influence of these factors on posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) was conceptualized used an ecological systems framework. Main effects of 13 empirically-supported predictor variables and interactive effects of race and racial-ethnic make-up of the neighborhood, race and crime, and crime and social support, were examined. Geographic information systems (GIS) technology was used to map neighborhood factors (e.g., racial-ethnic composition, employment rate, median income) and crime. Crime in the environment was mapped at address-level and aggregated to precinct-level, allowing us to examine measurement effects. In hierarchical regression analyses, peritraumatic response to IPV, longer elapsed time since IPV, and sexual IPV were associated with IPV-related PTSD. Exposure to more adverse events, longer elapsed time since IPV, and sexual IPV were associated with depression. Crime interacted with race to predict depression, although the nature of the interactions differed as a function of crime measurement. Precinct-level crime interacted with social support to predict depression. Sexual IPV and exposure to more adverse events were associated with GAD. These findings underscore the role of maintenance factors from multiple systems in symptomatology among women IPV survivors. They suggest that crime is a particularly relevant geographic factor impacting mental health. Clinical and policy implications are discussed, with attention to the utility of integrating GIS technology into future IPV and mental health-related endeavors

Executive Cognitive Functioning and Regulatory Deficits among Emerging Adult Nonmedical Prescription Opioid Users

Nonmedical prescription opioid (NMPO) use is elevated among emerging adults and may be related to deficits in executive cognitive functioning (ECF). This study examined relations between NMPO use, ECF deficits, and downstream consequences of poor self- and emotion regulation among emerging adults. Twenty-seven emerging adult NMPO users and 27 matched controls completed measures of ECF (working memory and interference control), self- and emotion regulation, and a clinical interview assessing substance use. NMPO users reported regulation deficits relative to controls, but groups did not differ on ECF measures. Among users, interference control was associated with NMPO use, working memory with alcohol use severity, and emotion regulation with NMPO use severity and marijuana use. Across groups, goal-directed and implusive behavior when distressed was associated with interference control. Engagement in goal-directed behavior when distressed was additionally associated with working memory. These findings should be extended to inform research, preveniton, and intervention

A Longitudinal Behavioral Economic Analysis of Non-medical Prescription Opioid Use Among College Students

Despite the growing opioid epidemic in the US, few studies have identified theoretically based risk factors for non-medical prescription opioid (NMPO) use among young adults. The goal of the current study was to evaluate the behavioral economic hypotheses that NMPO use would be associated with lower levels of reinforcement from substance-free activities and future time orientation. Participants were 71 undergraduate students (62% women, 52.1% Caucasian, 35.2% African American) who either reported past-year NMPO use or demographically similar control participants with no past-year drug use. Participants provided information on alcohol and drug use, completed three measures of substance-free reinforcement (time allocation to exercise and academic activities, hedonic response to substance-free pleasant images, and self-report anhedonia), and a measure of future orientation, at baseline, 6-month, and 12-month follow-up. Consistent with nationwide trends, most NMPO users also reported use of marijuana (94%) and alcohol (80%). Compared to no drug use, NMPO use was associated with lower time allocation to academic activities, lower hedonic response to pleasant images, greater self-reported anhedonia, and lower future orientation across the 12-month study period. Among NMPO users, greater positive hedonic response to substance-free pleasant images predicted less alcohol use at 12-month follow-up, and greater baseline future orientation predicted less marijuana and NMPO use at 12-month follow-up. These findings provide partial support for behavioral economic models that link substance misuse to diminished levels of substance-free reinforcement and lower consideration of the future

Impact of construal level manipulations on delay discounting

<div><p>Construal Level Theory states that psychologically proximal outcomes are construed concretely while psychologically distal outcomes are construed abstractly. Previous research suggests that the principles of Construal Level Theory can be applied to enhance self-control, as measured by delay discounting. The present studies replicate and expand on this work by examining whether theory-informed priming manipulations lead to delay discounting reductions in a repeated-measures design. Study 1 conceptually replicated previous work, with reduced delay discounting observed as a function of thinking abstractly. Studies 2 and 3 expanded on this work by reinterpreting (a) preference for immediate outcomes as preference for outcomes that are construed concretely, and (b) dispreference for delayed outcomes as dispreference for outcomes that are construed abstractly. Study 2 provided support for the first interpretation, as reduced delay discounting was observed as a function of thinking concretely about the future. Study 3 provided support for the second interpretation, as reduced delay discounting was observed as a function of thinking abstractly about the present. In studies 1 and 3, significant condition × order interactions were observed. In all three studies, the same impact of order of exposure to priming manipulation was observed, indicating specific carryover effects.</p></div

Elevated alcohol demand is associated with driving after drinking among college student binge drinkers

Background: Alcohol-impaired driving among college students represents a significant public health concern, yet little is known about specific theoretical and individual difference risk factors for driving after drinking among heavy drinking college students. This study evaluated the hypothesis that heavy drinkers with elevated alcohol demand would be more likely to report drinking and driving. Method: Participants were 207 college students who reported at least 1 heavy drinking episode (4/5 or more drinks in 1 occasion for a woman/man) in the past month. Participants completed an alcohol purchase task that assessed hypothetical alcohol consumption across 17 drink prices and an item from the Young Adult Alcohol Consequences Questionnaire that assessed driving after drinking. Results: In binary logistic regression models that controlled for drinking level, gender, ethnicity, age, and sensation seeking, participants who reported higher demand were more likely to report driving after drinking. Conclusions: These results provide support for behavioral economics models of substance abuse that view elevated/inelastic demand as a key etiological feature of substance misuse. © 2014 by the Research Society on Alcoholism

A behavioral economic analysis of the nonmedical use of prescription drugs among young adults

The nonmedical use of prescription drugs is a widely recognized public health issue, and young adults are particularly vulnerable to their use. Behavioral economic drug purchase tasks capture an individual\u27s strength of desire and motivation for a particular drug. We examined young adult prescription drug purchase and consumption patterns using hypothetical behavioral economic purchase tasks for prescription sedatives/tranquilizers, stimulants, and opiate pain relievers. We also examined relations between demand, use frequency, and Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) substance use disorder (SUD) symptoms, and sex differences in these relations. Undergraduate students who endorsed past-year prescription drug use (N = 393) completed an online questionnaire for course credit. Measures assessed substance use frequency and DSM-5 SUD symptoms. Hypothetical purchase tasks for sedatives, stimulants, and pain relievers assessed participants\u27 consumption and expenditure patterns for these substances across 25 prices. Past-year prescription sedative, stimulant, and pain reliever use was endorsed by 138, 258, and 189 participants, respectively. Among these users, consumption for their respective substance decreased as a function of ascending price, as expected. Demand indices for a prescription drug were associated with each other and with use frequency and SUD symptoms, with variability across substances but largely not by sex. In addition, demand for prescription pain relievers differentially predicted symptoms independent of use, with differences for females and males. In conclusion, hypothetical consumption and expenditure patterns for prescription drugs were generally well described by behavioral economic demand curves, and the observed associations with use and SUD symptoms provide support for the utility of prescription drug purchase tasks

Mean (±SE) log-transformed delay discounting (ln-<i>k</i>) in the two conditions of each study, by order of exposure to conditions.

<p>Study 1 (top panel): <i>Why</i> (gray bars) and <i>How</i> (black bars) conditions. The condition × order interaction is statistically significant, with lower delay discounting in the <i>Why</i> condition compared to <i>How</i> condition when the <i>How</i> condition occurred first. Study 2 (middle panel): <i>Concrete/Future</i> (gray bars) and <i>Concrete/Present</i> (black bars) conditions. Lower delay discounting was observed in the <i>Concrete/Future</i> condition, with no interaction. However, as with study 1, delay discounting was lower in the <i>Concrete/Future</i> condition compared to <i>Concrete/Present</i> when the <i>Concrete/Present</i> condition occurred first. Study 3 (bottom panel): <i>Abstract/Present</i> (gray bars) and <i>Abstract/Future</i> (black bars) conditions. As with study 1, the condition × order is statistically significant. As with studies 1 and 2, delay discounting was lower in the <i>Abstract/Present</i> condition compared to <i>Abstract/Future</i> when the <i>Abstract/Future</i> condition occurred first.</p

Participant characteristics.

<p>Participant characteristics.</p

Construal ratings for each condition in each study.

<p>Negative values indicate concrete construal and positive values abstract construal.</p