Negative affect variability as a potential mechanism of behavior change in alcohol use disorder treatment.

Objective: Negative affect and affect variability figure prominently in models of addictive behaviors but are not without controversy. Negative affect variability may better capture a mechanism of behavior change in alcohol use disorder (AUD) treatment because it contains information about affect regulation, a common clinical target. The aims of this study are to examine the change in: (a) trajectory of negative affect variability, (b) association of negative affect variability and abstinence, and (c) association of negative affect variability and heavy drinking during AUD treatment.

Predictors of National Institute on Alcohol Abuse and Alcoholism (NIAAA) Alcohol Recovery among Individuals in Alcohol Treatment: Implications for Social Work.

The National Institute on Alcohol Abuse and Alcoholism's (NIAAA) definition of alcohol use disorder (AUD) recovery stipulates two criteria: remission from DSM-5 AUD and cessation of heavy drinking. Importantly, these criteria allow for consideration of nonabstinent alcohol treatment outcomes. However, researchers have yet to assess potential predictors of the NIAAA recovery outcome.

Daily mindfulness homework completion is associated with reduced drinking during a mindfulness-enriched emotion regulation treatment for alcohol use disorder.

Homework is widely used in cognitive behavioral therapy (CBT) for alcohol use disorder (AUD). Theoretically, homework helps clients generalize skills acquired during treatment to their daily lives. However, clinical trials methodology has typically employed pre- and post-treatment assessments which has made evaluating the contribution of homework to behavior change a challenge.

Emotion differentiation among individuals in a randomized clinical trial for alcohol use disorder: Within- and between-person associations with affect, craving, and alcohol use in daily life.

Emotion differentiation refers to cognitively distinguishing among discrete, same-valenced emotions. Negative emotion differentiation (NED) is a transdiagnostic indicator of emotional functioning. The role of positive emotion differentiation (PED) in clinical disorders, including alcohol use disorder (AUD), is less understood.

Mechanisms of behavior change during alcohol treatment among negative affect drinkers: A time-varying effect model analysis using 84 consecutive days of ecological momentary assessment.

Objective: To better understand the timing and unique contribution of four potential mechanisms of behavior change (MOBC) during alcohol use disorder (AUD) treatment (negative affect, positive affect, alcohol craving, and adaptive alcohol coping), we used a time-varying effect modeling analytic approach to examine the change trajectories of alcohol abstinence, heavy drinking, the hypothesized MOBCs, and the time-varying associations between the MOBCs and alcohol outcomes.

Method: Participants ( = 181; = 50.8 years, = 10.

Pretreatment changes in drinking: A test of a tailored treatment approach.

Background: Pretreatment reductions in drinking are well documented and have been demonstrated to predict posttreatment drinking outcomes. Making use of the predictive value of pretreatment change has great appeal in settings that place a premium on efficient clinical decisions regarding appropriate type and intensity of treatment.

Methods: This study investigates whether different types and intensities of treatment are appropriate and beneficial for individuals entering treatment for an alcohol use disorder (AUD; N = 201) who make more vs.

Alexithymia disrupts emotion regulation processes and is associated with greater negative affect and alcohol problems.

Objective: Alexithymia is common among people who abuse alcohol, yet the mechanisms by which alexithymia exerts its influence remain unclear. This analysis tested a model whereby the three subscales of the Toronto Alexithymia Scale exert an indirect effect on alcohol problems through difficulties with emotion regulation and psychological distress.

Method: Men and women (n = 141) seeking alcohol use disorder (AUD) treatment completed the Toronto Alexithymia Scale, the Difficulties with Emotion Regulation Scale, the Brief Symptom Inventory, the Short Inventory of Problems, and the Alcohol Dependence Scale.

The Shape of Change: Determining When Mechanisms of Behavior Change Are Active in Cognitive Behavioral Treatment for Alcohol Use Disorder Using Time-Varying Effect Modeling (TVEM).

Objective: Research has identified several potential mechanisms of behavior change (MOBCs) in cognitive-behavioral therapy for alcohol use disorder, including alcohol abstinence self-efficacy (AASE), negative affect (NA), and positive affect (PA). However, little is known about when MOBCs affect clinical outcomes during alcohol use disorder treatment. Such information could advance MOBC research by identifying relationships between specific treatment content and variations in MOBCs.

The Great Disrupter: Relationship of Alexithymia to Emotion Regulation Processes and Smoking among Pregnant Women.

Many women continue to smoke during pregnancy, despite known risks, often in response to negative affect. Recent scholarship has begun to examine factors that decrease the success of behavioral treatments for smoking cessation in pregnancy, which are the preferred interventions. Alexithymia is one factor that may interfere with smoking cessation interventions.

Effect of e-cigarette flavors on nicotine delivery and puffing topography: results from a randomized clinical trial of daily smokers.

Rationale: There is limited understanding regarding how various e-cigarette flavorings may influence the behavior of non-regular e-cigarette users who are regular cigarette smokers.

Objectives: To assess differences in nicotine delivery, puffing topography, subjective effects, and user satisfaction from different flavored e-liquids.

Methods: Eighteen daily smokers (average age, 44.

The Identification of Pretreatment Trajectories of Alcohol Use and Their Relationship to Treatment Outcome in Men and Women With Alcohol Use Disorder.

Background: Few studies have focused on behavioral changes that occur prior to entering treatment for an alcohol use disorder (AUD). In 2 studies (Psychol Addict Behav, 27, 2013, 1159; J Stud Alcohol, 66, 2005, 369), pretreatment reductions in alcohol use were associated with better treatment outcomes. Identifying patterns of pretreatment change has the potential to inform clinical decision making.

Randomized within-subject trial to evaluate smokers' initial perceptions, subjective effects and nicotine delivery across six vaporized nicotine products.

Background And Aims: Vaporized nicotine products (VNPs) can vary in important characteristics including size, shape, flavor and nicotine yield. We examined whether complex interactions among these characteristics could affect smokers' VNP perceptions and usage patterns.

Design: A within-subject randomized cross-over trial.

Emotion regulation difficulties and social control correlates of smoking among pregnant women trying to quit.

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.

Difficulties in emotion regulation in treatment-seeking alcoholics with and without co-occurring mood and anxiety disorders.

Emotion regulation difficulties (ERD) are known to underlie mental health conditions including anxiety and depressive disorders and alcohol use disorder (AUD). Although AUD, mood, and anxiety disorders commonly co-occur, no study has examined the association between these disorders and ERD among AUD outpatients. In the current study, emotion regulation (ER) scores of AUD individuals with no co-occurring mental health condition were compared to the ER scores of individuals who met diagnostic criteria for co-occurring mood and/or anxiety disorders.

Smoking Cessation for Pregnant Smokers: Development and Pilot Test of an Emotion Regulation Treatment Supplement to Standard Smoking Cessation for Negative Affect Smokers.

Introduction: Negative affect has been identified as a factor influencing continued smoking during pregnancy. In this study, a multi-component emotion regulation intervention was developed to address negative emotional smoking triggers and pilot-tested among low-income pregnant smokers. Treatment feasibility and acceptability, cotinine-verified rates of smoking cessation, and self-report of mean cigarettes smoked were assessed.

Behavioral Interventions for Individuals Dually-Diagnosed with a Severe Mental Illness and a Substance Use Disorder.

The prevalence of substance abuse among severely mentally ill individuals (SMI) with a schizophrenia-spectrum or bipolar disorder is about three times the rate of the general population. However, few effective interventions exist to address the problem. In this paper, we evaluate recent studies of behavioral interventions for substance abuse among SMI individuals.

A longitudinal analysis of drinking and victimization in college women: is there a reciprocal relationship?

The purpose of the current study was to assess the relationship between drinking and severe physical and sexual victimization in a sample of 989 college women over 5 years. Participants completed a Web-based survey each fall semester, beginning as first-time incoming freshman, and continuing each year for 5 years. The survey was comprehensive in assessing drinking, victimization, and relevant covariates.

The influence of treatment attendance on subsequent aggression among severely mentally ill substance abusers.

The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagnosed with both a severe mental illness and a substance use disorder. We also tested substance use and psychiatric symptoms as mediators of this treatment-aggression relationship.

Alcohol craving in patients diagnosed with a severe mental illness and alcohol use disorder: bidirectional relationships between approach and avoidance inclinations and drinking.

Objective: The current study was undertaken to better understand the craving-drinking relationship among individuals dually diagnosed with a severe mental illness (SMI) and an alcohol use disorder (AUD). Using an ambivalence conceptualization of craving (Breiner, Stritzke, & Lang, 1999), we investigated the bidirectional relationships between desires and behavioral intentions to use (approach inclinations) and not use (avoidance inclinations) alcohol and drinking outcomes in patients diagnosed with an SMI-AUD.

Method: Patients (N = 278) seeking outpatient dual diagnosis treatment from a community mental health center were followed longitudinally over the course of 6 months.

Affect regulation training (ART) for alcohol use disorders: development of a novel intervention for negative affect drinkers.

Although negative affect is a common precipitant of alcohol relapse, there are few interventions for alcohol dependence that specifically target negative affect. In this stage 1a/1b treatment development study, several affect regulation strategies (e.g.

Pretreatment changes in drinking: relationship to treatment outcomes.

Pretreatment changes in alcohol use challenges the assumption that the major portion of the change process occurs after treatment entry. Greater understanding of the behavior change process prior to treatment has the potential to improve our understanding of behavioral changes during treatment. In this study, participants (N = 45) were recruited for a clinical trial examining multiple mechanisms of change in cognitive-behavioral treatment for alcohol dependence.

Relationship between approach and avoidance inclinations to use alcohol and treatment outcomes.

Background: Despite growing recognition of the importance of multidimensional assessments of craving, little is known about how both approach and avoidance of alcohol inclinations change during the course of treatment, or relate to treatment outcomes. The current study examined the relationship between approach inclinations, avoidance inclinations, and treatment outcomes in individuals seeking treatment for alcohol dependence, and investigated whether changes in approach and avoidance ratings were associated with changes in drinking.

Methods: Individuals (n=81) seeking treatment for alcohol dependence were randomized to receive either 12-sessions of cognitive-behavioral therapy plus healthy living skills or 12-sessions of cognitive-behavioral therapy plus affect regulation training.

The relationship of alexithymia to emotional dysregulation within an alcohol dependent treatment sample.

Difficulties regulating emotions have implications for the development, maintenance, and recovery from alcohol problems. One construct thought to impede the regulation of emotion is alexithymia. Alexithymia is characterized by difficulties identifying, differentiating and expressing feelings, a limited imagination and fantasy life, and an externally-oriented thinking style (e.

A beverage-specific measure of expectancies for malt liquor: development and initial testing.

Malt liquor (ML) is a unique, high alcohol content beverage marketed to encourage heavy drinking. We developed the Malt Liquor Expectancy Questionnaire (MLEQ), a beverage-specific measure of alcohol expectancies, and examined its association with typical weekly ML use, typical weekly alcohol use, and alcohol problems. Forty positive and 40 negative expectancy items were administered to a sample of 639 young adults who regularly consumed ML.