Finding the Middle Path Between Dependence and Autonomy: Recent Trainee Experiences in Dialectical Behavior Therapy Supervision

Originally published in DBT Bulletin Volume 3, Issue 1 pages 28-32 (2020). The DBT Bulletin is published by DBT California

Do drinking consequences predict sexual revictimization in a college sample of binge-drinking women?

Thesis (Master's)--University of Washington, 2014Sexual victimization is prevalent on college campuses in the US. A proportion of women experience multiple sexual assaults, and sexual assault risk in college is heightened among those with prior victimization histories. One risk factor for sexual revictimization is victims' alcohol use. Most research has focused on associations between alcohol consumption per se and revictimization. The current study's objective was to understand some potential mechanisms by which drinking confers risk for revictimization. We hypothesized specific drinking consequences would predict risk for revictimization above and beyond the quantity of alcohol consumed. A randomly selected sample of binge drinking female college students was assessed for baseline victimization (categorized as childhood versus adolescent victimization), quantity of alcohol consumed, and drinking consequences experienced. A subset of 162 women was assessed 30 days later for revictimization. Of the subset, 40 (24.6%) women were revictimized in the following 30 days. Blackout drinking at baseline predicted incapacitated sexual revictimization among women previously victimized as adolescents, after accounting for quantity of alcohol consumed. Other drinking consequences examined were not predictive of revictimization. Results support previous findings that adolescent sexual assault is an important predictor of sexual revictimization in college and blackout drinking may confer unique risk for revictimization

Feasibility, acceptability, and outcomes of a brief mindfulness intervention for college students with posttraumatic stress symptoms and problem drinking

Thesis (Ph.D.)--University of Washington, 2017-08The majority of college students will experience a traumatic event either before or during college, and a significant subset of those students experience PTSD symptoms. Additionally, many college students engage in problematic alcohol use. There is evidence that individuals with co-occurring PTSD symptoms and alcohol and other substance use disorders often use substances in an attempt to reduce their PTSD symptoms, and college students with PTSD symptoms experience more negative alcohol and drug consequences than those without PTSD. The relationship between PTSD and alcohol and other substance use disorders is often cyclical: individuals use substances to cope with PTSD symptoms, which in turn exacerbate symptoms and make them vulnerable to further traumatic experiences. Mindfulness interventions have been successfully utilized for individuals with PTSD or substance use disorders. However, to date, no previous studies have evaluated treatments for college students with co-occurring PTSD symptoms and problem drinking. This study evaluated the feasibility, acceptability, and efficacy of a 4-week group loving-kindness meditation (LKM) compared to referral to treatment as usual (RTAU) for college students with PTSD symptoms and problem drinking. Seventy-six college students participated in the current study. Overall, the LKM group was feasible and acceptable to college students, although recruitment of eligible students into the study was lower than expected and attendance at LKM groups was modest. Participants’ PTSD symptoms, drinking quantity, and negative drinking consequences decreased over the course of the study, although there was no significant differences between the LKM and RTAU conditions on these outcomes. Additionally, higher coping drinking motives predicted greater PTSD symptoms and more drinking consequences, highlighting the need for early effective intervention for individuals who drink to cope with their PTSD symptoms

Does mindfulness moderate the relationship between protective behavioral strategies and alcohol use in high school seniors?

Decreases in alcohol consumptions have been linked to the use of protective behavioral strategies (PBS) a number of times (Arterberry et al., 2014; Kenny et al., 2014; & Braitman et al., 2014). Trait mindfulness has been researched looking for a link in substance use treatment. Promising results have been found (Grow et al., 2015; Vinci et al., 2014) that have led to the creation of treatment modalities such as Mindfulness-Based Relapse Prevention (Bowen, Charla, Marlatt, 2010). The present study investigates the relation between PBS, mindfulness, and negative outcomes due to alcohol consumption. The participants are part of a larger study (N = 3,352) investigating a brief online alcohol use intervention amongWashington state (n = 1,181) and Swedish high school seniors (n = 2,171). Data was collected at a six-month follow-up via an online survey. Participants completed the 15-item Protective Behavioral Strategies Scale that measures PBS with responses ranging from 1-Never to 6-Always (PBSS; Martens et al., 2007); a 12-item trait mindfulness measure with responses ranging from1-Rarely/Not at all to 4-Almost always (Cognitive and AffectiveMindfulness Scale Revised; Feldman et al., 2007); and the Young Adult Alcohol Problem Screening Test (Hurlbut & Sher, 1992), which measures social and personal problems related to drinking. A regression analysis was performed to assess the relationship between the measures. Significant main effects were found for PBS (p < 0.001) and mindfulness (p < 0.01) on negative consequences of alcohol use. However, there was no moderating effect of mindfulness on the relation between PBS and negative effects of alcohol (p = 0.10). Results support past research on the impact of mindfulness on negative effects of alcohol. Results regarding PBS were not consistent with past literature regarding their impact on decreasing negative effects of alcohol. This may be attributed to a relationship between those individuals using PBS and the amount of negative drinking consequences they already experience. There was not enough evidence to suggest amoderating effect ofmindfulness as a factor that would further decrease negative alcohol effects. Future research could investigate whether a treatment designed to increase the effectiveness of PBS through increased mindfulness is a suitable intervention. This research was supported by NIAAA # 5R01AA018276 awarded to Drs. Larimer & Berglund

Facets of mindfulness predict drinking consequences in a sample of American and Swedish adolescents

Mindfulness-based interventions have become increasingly utilized with individuals with alcohol and substance use disorders (e.g., Bowen et al., 2014); however, the relationship between mindfulness and substance use is complex (Karyadi et al., 2014). Mindfulness is a multifaceted construct and includes factors related to attentional control, present moment focus, and an attitude of non-judgment and acceptance. Thus, the relationship between different mindfulness factors and substance use, and negative consequences related to its use, may differ. In the present study, we examined which specific elements of mindfulness would best predict drinking consequences 6 months later in a sample of American and Swedish adolescents. Additionally, we examined whether adolescents’ nationality would moderate the relationship between mindfulness and drinking consequences. Our sample included Washington St, USA and Swedish adolescents participating in a larger study investigating a brief online intervention for alcohol use (N = 3,352). Participants completed an online survey at 6- and 12-month follow up. At the 6-month follow up, trait-mindfulness wasmeasured using the Cognitive and AffectiveMindfulness Scale-Revised (Feldman et al., 2007). At 12-month follow up, alcohol related negative consequences were measured using the Rutgers Alcohol Problem Index (White & Lobouvie, 1989). Linear regression analysis revealed that mindfulness factors did explain a significant proportion of variance in drinking consequences scores, R2 = 0.02, F(4, 620) = 2.67, p = 0.03. Specifically, the mindfulness factor of attention predicted drinking consequences, such that lower levels of attention predictedmore drinking consequences, b = 0.23, p = 0.02. None of the other mindfulness factors significantly predicted drinking consequences. Adolescents’ nationality did notmoderate the relationship between the mindfulness factors and drinking consequences 6 month later. The present study findings differ from previous findings, which found a relationship between awareness and drinking consequences (Fernandez et al., 2010), although this may be due to differences in how mindfulness factors were conceptualized and assessed. Nationality was not shown to moderate the relationship between mindfulness factors and drinking consequences, suggesting that mindfulness factors may not be culturally bound and may operate consistently across cultures, although examination of additional cultures is needed