Nonmedical Use of Prescription Drugs Among Young Adults: An Examination of Anxiety Sensitivity, Distress Tolerance, and Emotion-Driven Impulse Control Difficulties

Individuals with anxiety disorders are significantly more likely to develop substance use disorders than those without anxiety disorders (Kessler & Greenberg, 2002). Despite a sizeable body of literature focused on etiological and maintenance factors underlying the co-occurrence of substance use and anxiety pathology, this relationship remains poorly understood. Transdiagnostic factors, specifically distress tolerance, anxiety sensitivity, and emotion-driven impulse control difficulties, have been posited to contribute to the relationship of anxiety and substance abuse, and in particular, nonmedical use of prescription drugs (NMUPD; Dennhardt & Murphy, 2013; Wolitzky-Taylor et al., 2015). The current study examined group differences among the aforementioned transdiagnostic factors, and whether they served as mediators in the relation of anxiety and NMUPD in a sample of college students. Participants were 184 undergraduate students at the University of Mississippi who either engaged in past year NMUPD or did not. All participants completed a battery of questionnaires and participated in a laboratory task. Counter to the hypotheses, results indicated that there were not significant differences in the transdiagnostic variables among the two groups, and that none of the transdiagnostic variables mediated the relation of anxiety and NMUPD. Compared to non-drug users, drug users reported more substance use overall, including polysubstance use, and reported more self-medication motives for NMUPD than a similar sample of undergraduate students. The findings are consistent with the extant literature indicating that college students who engage in past year NMUPD are at increased risk for other substance abuse, including simultaneous polysubstance use. Future studies should further examine risk factors for NMUPD among college students

Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder

© 2019 Hofmann et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with nonclinical human samples in de novo fear conditioning paradigms have demonstrated minimal to no benefit of DCS. The aim of this study was to evaluate the effects of DCS on the retention of extinction learning following de novo fear conditioning in a clinical sample. Eighty-one patients with social anxiety disorder were recruited and underwent a previously validated de novo fear conditioning and extinction paradigm over the course of three days. Of those, only 43 (53%) provided analyzable data. During conditioning on Day 1, participants viewed images of differently colored lamps, two of which were followed by with electric shock (CS+) and a third which was not (CS-). On Day 2, participants were randomly assigned to receive either 50 mg DCS or placebo, administered in a double-blind manner 1 hour prior to extinction training with a single CS+ in a distinct context. Day 3 consisted of tests of extinction recall and renewal. The primary outcome was skin conductance response to conditioned stimuli, and shock expectancy ratings were examined as a secondary outcome. Results showed greater skin conductance and expectancy ratings in response to the CS+ compared to CS- at the end of conditioning. As expected, this difference was no longer present at the end of extinction training, but returned at early recall and renewal phases on Day 3, showing evidence of return of fear. In contrast to hypotheses, DCS had no moderating influence on skin conductance response or expectancy of shock during recall or renewal phases. We did not find evidence of an effect of DCS on the retention of extinction learning in humans in this fear conditioning and extinction paradigm

Do Individuals with Functional Gastrointestinal Symptoms Experience Emotions Differently? An Examination of Emotional Responding During a Series of Emotion Induction Tasks

Functional gastrointestinal disorders (FGIDs) are disorders of the brain-gut axis characterized by physiological and emotional disturbances, including heightened comorbidity with psychiatric disorders. Individuals with FGIDs experience difficulties with emotional processing, including the awareness, identification, and regulation of emotions. Although emotional processing is implicated in the maintenance and exacerbation of FGID pathology, literature examining these associations is limited. The current study aimed to enhance understanding of the emotional processing of individuals with FGIDs. We recruited individuals with and without FGID symptoms and examined the: (1) association between gastrointestinal distress and psychopathology; (2) association between gastrointestinal distress and emotional and physiological responsivity; (3) awareness, identification, and intensity of emotional experiences; and (4) distress, emotion regulation abilities, and deployment of specific emotion regulation strategies during emotion inductions. In total, 291 university students (Mage = 20.59; SD = 5.50; 72.5% female; 82.5% White) completed an online battery of self-report questionnaires. A portion of participants (n = 52) engaged in a neutral induction and a series of experimental emotion inductions to elicit anxiety, disgust, and sadness. Gastrointestinal distress was positively correlated with psychopathology and physiological and emotional responsivity, but not use of emotion regulation strategies. Throughout emotion inductions, participants in the FGID and control groups did not differ in their differentiation of negative emotions, distress, or emotion regulation. One significant within-subjects main effect of induction emerged, such that SUDS following the emotion inductions were higher than following the neutral induction, and that anxiety and disgust resulted in greater SUDS than the sadness induction. Consistent with extant literature, findings suggest that college students may be at risk for FGID symptoms, and that gut symptoms are associated with both heightened emotional and physiological reactivity. Significant and null findings must be considered in the light of several limitations, including a nonclinical sample of participants with relatively low gastrointestinal distress, novel videoconferencing methodology, and data collection during a global pandemic. Future studies should replicate and extend this study by using a larger, in-person sample of individuals with verified FGIDs to determine whether functional gastrointestinal symptoms are indeed associated with difficulties distinguishing and regulating emotions

The Relationship between Traumatic Life Events and Hoarding Symptoms: A Multi-Method Approach

Hoarding Disorder is characterized by difficulties with discarding and frequently excessively acquiring possessions, resulting in substantial clutter. Previous research has implicated trauma in the development of hoarding, but no study to date has examined the relationship between trauma and hoarding using hypothetical hoarding paradigms. This study investigated the association between traumatic events and both self-report and hypothetical indices of hoarding symptoms. We predicted that frequency of trauma would be associated with greater hoarding symptoms (across self-report and hypothetical indices). Undergraduate students (N = 80) completed self-report measures of hoarding symptoms and trauma, and hypothetical measures of acquiring and saving tendencies. As expected, more frequent trauma, and physical/sexual trauma in particular, was associated with greater acquiring tendencies. However, frequency of trauma was not significantly correlated with saving tendencies or self-reported hoarding symptoms. Future research should replicate these findings using longitudinal designs to confirm whether trauma actually serves as a risk factor for hoarding. Replication in a clinical sample is needed to better understand the implications of these results for intervention

Psychological and pharmacological treatments for generalized anxiety disorder (GAD): a meta-analysis of randomized controlled trials

The purpose of this meta-analysis was to provide updated pooled effect sizes of evidence-based psychotherapies and medications for generalized anxiety disorder (GAD) and to investigate potential moderators of outcomes. Seventy-nine randomized controlled trials (RCT) including 11,002 participants with a diagnosis of GAD were included in a meta-analysis that tested the efficacy of psychotherapies or medications for GAD. Psychotherapy showed a medium to large effect size (g = 0.76) and medication showed a small effect size (g = 0.38) on GAD outcomes. Psychotherapy also showed a medium effect on depression outcomes (g = 0.64) as did medications (g = 0.59). Younger age was associated with a larger effect size for psychotherapy (p < 0.05). There was evidence of publication bias in psychotherapy studies. This analysis found a medium to large effect for empirically supported psychotherapy interventions on GAD outcomes and a small effect for medications on GAD outcomes. Both groups showed a medium effect on depression outcomes. Because medication studies had more placebo control conditions than inactive conditions compared to psychotherapy studies, effect sizes between the domains should not be compared directly. Patient age should be further investigated as a potential moderator in psychotherapy outcomes in GAD

Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder.

Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with non-clinical human samples in de novo fear conditioning paradigms have demonstrated minimal to no benefit of DCS. The aim of this study was to evaluate the effects of DCS on the retention of extinction learning following de novo fear conditioning in a clinical sample. Eighty-one patients with social anxiety disorder were recruited and underwent a previously validated de novo fear conditioning and extinction paradigm over the course of three days. Of those, only 43 (53%) provided analyzable data. During conditioning on Day 1, participants viewed images of differently colored lamps, two of which were followed by with electric shock (CS+) and a third which was not (CS-). On Day 2, participants were randomly assigned to receive either 50 mg DCS or placebo, administered in a double-blind manner 1 hour prior to extinction training with a single CS+ in a distinct context. Day 3 consisted of tests of extinction recall and renewal. The primary outcome was skin conductance response to conditioned stimuli, and shock expectancy ratings were examined as a secondary outcome. Results showed greater skin conductance and expectancy ratings in response to the CS+ compared to CS- at the end of conditioning. As expected, this difference was no longer present at the end of extinction training, but returned at early recall and renewal phases on Day 3, showing evidence of return of fear. In contrast to hypotheses, DCS had no moderating influence on skin conductance response or expectancy of shock during recall or renewal phases. We did not find evidence of an effect of DCS on the retention of extinction learning in humans in this fear conditioning and extinction paradigm

A preliminary investigation of the role of intraindividual sleep variability in substance use treatment outcomes

Introduction: Poor sleep health is common among individuals in early treatment for substance use disorders (SUDs) and may serve an important role in predicting SUD outcomes. However, sleep parameters have been inconsistently linked with risk of relapse, perhaps because previous research has focused on mean values of sleep parameters (e.g., total sleep time [TST], sleep efficiency [SE], and sleep midpoint [SM]) across multiple nights rather than night-to-night fluctuations (i.e., intraindividual variability [IIV]). The current study assessed sleep across the first week of SUD treatment, with the aim of prospectively examining the relationship between mean and IIV of TST, SE, and SM and treatment completion and relapse within one-month post-treatment. Methods: Treatment-seeking adults (N = 23, Mage = 40.1, 39% female) wore an actigraph to assess sleep for one week at the beginning of an intensive outpatient program treatment. Electronic medical record and follow-up interviews were utilized to determine treatment outcomes. Results: Greater IIV in TST was associated with higher odds of relapse (OR = 3.55, p =.028). Greater IIV in SM was associated with lower odds of treatment completion, but only when removing mean SM from the model (OR = 0.75, p =.046). Discussion: Night-to-night variability in actigraphy-measured TST is more strongly associated with SUD treatment outcomes than average sleep patterns across the week. Integrating circadian regulation into treatment efforts to improve SUD treatment outcomes may be warranted. Given the small sample size utilized in the present study, replication of these analyses with a larger sample is warranted.24 month embargo; available online: 24 March 2022This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]