Buffering the Associations Between Negative Mood States and the Incentive Salience of Alcohol: A Brief Mindfulness Induction

The present study examined drinking to cope (DTC) motives and state mindfulness (via a brief mindfulness induction) as two distinct factors that may enhance (DTC) and reduce (state mindfulness) the association between negative mood states (i.e., sadness and anxiety) and the incentive salience of alcohol (i.e., subjective alcohol craving and attentional bias for alcohol-related cues) among college student drinkers. Participants were 207 undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month. The majority of participants identified as being either White, non-Hispanic (n = 81; 39.1%), or African-American (n = 86; 41.6%), were female (n = 170; 82.1%), and reported a mean age of 20.94 (SD = 5.48) years. Results indicated that at both pre and post-mindfulness induction assessments, higher levels of both DTC-depression and DTC-anxiety motives were related to higher subjective alcohol craving. Further, collapsing across mood groups (i.e., sadness vs mood control) and at average levels of both DTC-depression and DTC-anxiety motives, individuals in the mindfulness condition reported a significant change score (i.e., reduction) in subjective alcohol craving scores at post-mindfulness induction compared to individuals in the no-mindfulness condition. Albeit preliminary, the present study offers support for mindfulness as a beneficial alternative coping strategy to drinking to cope among college student drinkers. Future work is needed to replicate these findings and examine how DTC motives, emotional mood states, and state mindfulness interrelate among college student drinkers within an ecological momentary framework

The Effects of Religious Coping and Drinking to Cope on the Relationship Between Depressive Symptoms and Alcohol-Related Problems

The present research examined the moderating effect of religious coping (positive or negative) on the relationship between depressive symptoms and alcohol-related problems. Furthermore, the current study examined the moderating effects of positive and negative religious coping in the context of the confirmed mediation of drinking to cope on depression and alcohol related problems (i.e., moderated-mediation). The study consisted of 294 religious undergraduate student drinkers from a large southeastern university. The majority of participants identified themselves as Christian (n = 257, 87.4%), were female (n = 218, 74.1%), and reported a mean age of 21.85 (SD = 5.57) years. Participants completed measures of depressive symptoms, alcohol use, alcohol-related problems, drinking to cope, and religious coping. The present study found partial support for the Maladaptive Coping Hypothesis among religious college student drinkers. In particular, negative religious coping moderated the relationship between depressive symptoms and alcohol-related problems. In addition, negative religious coping affects another maladaptive coping strategy (i.e., drinking to cope) by moderating the meditating effects of drinking to cope on the relationship between depressive symptoms and alcohol-related problems. However, positive religious coping was unrelated to all major study variables. The implication of this study may be important for future interventions to tap into improving coping strategies for religious individuals who report high levels of depressive symptoms

Drinking to Cope With Depressive Symptoms and Ruminative Thinking: A Multiple Mediation Model Among College Students

Background: Understanding the potential psychosocial mechanisms that explain (i.e., mediate) the associations between depressive symptoms and alcohol-related problems can improve interventions targeting college students. Objectives: The current research examined four distinct facets of rumination (e.g., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) and drinking to cope motives as potential explanatory mechanisms by which depressive symptoms are associated with increased alcohol-related problems. Method: Participants were undergraduate students from a large, southeastern university in the United States that consumed at least one drink per typical week in the previous month (n = 403). The majority of participants were female (n = 291; 72.2%), identified as being either White, non-Hispanic (n = 210; 52.1%), or African American (n= 110; 27.3%), and reported a mean age of 21.92 (SD=5.75) years. Results: Structural equation modeling was conducted examining the concurrent associations between depressive symptoms, rumination facets, drinking to cope motives, and alcohol-related problems (i.e., cross-sectional). There was one significant double-mediated association that suggested that increased depressive symptoms is associated with increased problem-focused thoughts, which is associated with higher drinking to cope motives and alcohol-related problems. Conclusions/Importance: Our results suggests that problem focused thoughts at least partially explains the associations between depression and maladaptive coping (i.e., drinking to cope), which in turn is related to problematic drinking among college students. Limitations and future directions are discussed

Finding Success in Failure: Using Latent Profile Analysis to Examine Heterogeneity in Psychosocial Functioning Among Heavy Drinkers Following Treatment

Aims- To estimate differences in post-treatment psychosocial functioning among treatment failures\u27 (i.e. heavy drinkers, defined as 4+/5+ drinks for women/men) from two large multi-site clinical trials and to compare these levels of functioning to those of the purported treatment successes\u27 (i.e. non-heavy drinkers). Design- Separate latent profile analyses of data from two of the largest alcohol clinical trials conducted in the United States, COMBINE (Combined Pharmacotherapies and Behavioral Interventions) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity), comparing psychosocial outcomes across derived classes of heterogeneous treatment responders. Setting- Eleven US academic sites in COMBINE, 27US treatment sites local to nine research sites in Project MATCH. ParticipantsA total of 962 individuals in COMBINE (69% male, 77% white, mean age: 44years) treated January 2001 to January 2004 and 1528 individuals in Project MATCH (75% male, 80% white, mean age: 40years) treated April 1991 to September 1994. MeasurementsIn COMBINE, we analyzed health, quality of life, mental health symptoms and alcohol consequences 12 months post-baseline. In Project MATCH, we examined social functioning, mental health symptoms and alcohol consequences 15 months post-baseline. Findings- Latent profile analysis of measures of functioning in both samples supported a three-profile solution for the group of treatment failures\u27, characterized by high-, average- and low-functioning individuals. The high-functioning treatment failures\u27 generally performed better across measures of psychosocial functioning at follow-up than participants designated treatment successes\u27 by virtue of being abstainers or light drinkers. Conclusions- Current United States Food and Drug Administration guidance to use heavy drinking as indicative of treatment failure\u27 fails to take into account substantial psychosocial improvements made by individuals who continue occasionally to drink heavily post-treatment

Mindfulness and Emotional Outcomes: Identifying Subgroups of College Students Using Latent Profile Analysis

In non-meditating samples, distinct facets of mindfulness are found to be negatively correlated, preventing the meaningful creation of a total mindfulness score. The present study used person-centered analyses to distinguish subgroups of college students based on their mindfulness scores, which allows the examination of individuals who are high (or low) on all facets of mindfulness. Using the Lo-Mendell-Rubin Adjusted LRT test, we settled on a 4-class solution that included a high mindfulness group (high on all 5 facets, N = 245), low mindfulness group (moderately low on all 5 facets, N = 563), judgmentally observing group (high on observing, but low on non-judging and acting with awareness, N= 63), and non-judgmentally aware group (low on observing, but high on non-judging and acting with awareness, N= 70). Consistent across all emotional outcomes including depressive symptoms, anxiety symptoms (i.e., worry), affective instability, and distress intolerance, we found that the judgmentally observing group had the most maladaptive emotional outcomes followed by the low mindfulness group. Both the high mindfulness group and the non-judgmentally aware group had the most adaptive emotional outcomes. We discuss the implications of person-centered analyses to exploring mindfulness as it relates to important psychological health outcomes

Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope

Objective: In college student samples, the association between depressive symptoms and alcohol-related problems has been found to be mediated by drinking-to-cope motives. Mindfulness-based interventions suggest that mindfulness may attenuate the conditioned response of using substances in response to negative emotional states, and trait mindfulness has been shown to be a protective factor associated with experiencing fewer alcohol-related problems. In the present study, we examined trait mindfulness as a moderator of the indirect associations of depressive symptoms on alcohol-related problems via drinking-to-cope motives. Method: Participants were undergraduate students at a large, southeastern university in the United States who drank at least once in the previous month (n = 448). Participants completed an online survey regarding their personal mental health, coping strategies, trait mindfulness, and alcohol use behaviors. The majority of participants were female (n = 302; 67.4%), identified as being either White non Hispanic (n = 213; 47.5%) or African American (n = 119; 26.6%), and reported a mean age of 22.74 (SD = 6.81) years. Further, 110 (25%) participants reported having a previous and/or current experience with mindfulness mediation. Results: As hypothesized, the indirect effects from depressive symptoms to alcohol-related problems via drinking-to-cope motives were weaker among individuals reporting higher levels of mindfulness than among individuals reporting lower and average levels of mindfulness. Conclusions: The present study suggests a possible mechanism through which mindfulness-based interventions may be efficacious among college students: decoupling the associations between depressive symptoms and drinking-to-cope motives

Five Facets of Mindfulness and Psychological Health: Evaluating a Psychological Model of the Mechanisms of Mindfulness

There has been an increasing focus on determining the psychological mechanisms underlying the broad effects of mindfulness on psychological health. Mindfulness has been posited to be related to the construct of reperceiving or decentering, defined as a shift in perspective associated with decreased attachment to one\u27s thoughts and emotions. Decentering is proposed to be a meta-mechanism that mobilizes four psychological mechanisms (cognitive flexibility, values clarification, self-regulation, and exposure), which in turn are associated with positive health outcomes. Despite preliminary support for this model, extant studies testing this model have not examined distinct facets of mindfulness. The present study used a multidimensional measure of mindfulness to examine whether this model could account for the associations between five facets of mindfulness and psychological symptoms (depressive symptoms, stress, anxiety symptoms, alcohol-related problems) in a sample of college students (N = 944). Our findings partially support this model. We found significant double-mediated associations in the expected directions for all outcomes (stress, anxiety symptoms, and depressive symptoms) except alcohol-related problems, and for each of the facets of mindfulness except observing. However, decentering and the specific mechanisms did not fully mediate the associations among mindfulness facets and psychological health outcomes. Experimental and ecological momentary assessment designs are needed to understand the psychological processes that account for the beneficial effects of mindfulness

Post-Traumatic Stress and Marijuana outcomes: The Mediating Role of Marijuana Protective Behavioral Strategies

Background: The present study investigated the mediating role of protective behavioral strategies for marijuana (PBSM) on the relationship between posttraumatic stress disorder (PTSD) and marijuana outcomes (i.e. marijuana use frequency, marijuana use quantity, cannabis use disorder (CUD) symptoms, and marijuana-related problems). Methods: Participants were 1,107 traditional age college students (Mage = 20.26, SD = 3.32; 66.5% White, non-Hispanic; 68.8% female), who reported consuming marijuana at least once in the last 30 days and completed measures of PTSD symptoms, PBSM, and marijuana-related outcomes. Results: PBSM significantly mediated the positive relationships between PTSD symptoms and both CUD symptoms and marijuana-related problems. More specifically, PTSD symptoms were negatively associated with PBSM, which in turn was negatively associated with marijuana use frequency and marijuana use quantity, which were in turn positively associated with CUD symptoms and marijuana-related problems. Conclusion: Taken together, the associations between higher PTSD symptoms and greater experience of CUD symptoms and marijuana-related problems may occur because students use fewer PBSM and thus engage in larger quantity and frequency of marijuana use. These findings lend support to the utility of targeting PBSM as a harm reduction effort for students with PTSD symptoms who use marijuana

The Relationship Between Social Anxiety and Alcohol and Marijuana Use Outcomes Among Concurrent Users: A Motivational Model of Substance Use

Background: College students with more social anxiety symptoms are particularly vulnerable to problematic alcohol and marijuana use given their susceptibility for elevated anxiety symptoms in social settings combined with the normative nature of substance use. Existing research has established substance use as coping motivated for these students when examining alcohol and marijuana use problems separately. The next step is to determine whether students with more social anxiety who use both substances do so for similar or different reasons. The current study tested a comprehensive (i.e., all variables in the same model) motivational model of alcohol/marijuana use in a sample of college students from 10 universities across the United States who endorsed both past-month alcohol and marijuana use. Methods: College students were recruited through psychology department participant pools and completed an online survey assessing mental health symptoms, substance use motives, and substances use behaviors. Current sample comprised concurrent alcohol/marijuana users (n = 2,034), 29.6% of whom endorsed clinically indicated levels of social anxiety and nearly one-fourth exceeded the cutoff for hazardous drinking (23.2%) and hazardous marijuana use (21.9%). Results: Across both substances, coping motives significantly mediated the positive relationship between social anxiety symptoms and substance use problems. Unique to alcohol, conformity motives mediated the association between social anxiety symptoms and alcohol-related problems. Conclusions: Taken together, students with more social anxiety who are focused on anxiety management may use either alcohol or marijuana; however, these students may experience more alcohol-related problems when drinking to fit in with peers

Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse

Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6 month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers\u27 and fathers\u27 risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD