The role of parental maladaptive emotion socialization in the risk process for negative urgency and drinking behavior in adolescence.

INTRODUCTION: Negative urgency (the tendency to act rashly when experiencing negative emotions) is a robust risk factor for a number of problem behaviors, including early adolescent drinking. Little is known about the factors that precede the development of negative urgency, and hence the full etiology of this component of risk. The current study aimed to investigate the possibility that facets of childhood maladaptive emotion socialization (the tendency for children's expressions of emotions to be met with punishment, minimized, or invoke a reaction of distress from their parents/caretakers) increases risk for the development of negative urgency and drinking behavior. METHOD: Self-report measures of negative urgency, subfacets of maladaptive emotion socialization, and drinking behavior were collected during the 2021-2022 academic year from a sample of 428 high school students (mean age = 14.7, SD = 0.09, 44% female), assessed twice over the course of a semester, reflecting a 4-month longitudinal window. RESULTS: Distress emotion socialization predicted increases in negative urgency, minimizing predicted decreases in negative urgency, and punitive did not provide significant prediction. Additionally, results found that higher levels of both negative urgency and distress emotion socialization increased adolescents' likelihood of having tried alcohol. These processes were invariant across race and gender. CONCLUSIONS: The present study may inform the future creation of prevention and intervention efforts aimed at reducing maladaptive emotion socialization and increasing adaptive emotion socialization. Successful reductions in negative urgency as a consequence of increased adaptive emotion socialization may then lead to decreases in adolescent drinking and other impulsigenic behaviors.

Addressing the SUD training gap: Two pilot feasibility studies in the Department of Veteran's Affairs Health Care System.

INTRODUCTION: Substance use disorders (SUDs) are an ongoing public health crisis in the United States. A large body of research indicates an urgent need for increased training in SUD research and treatment for trainees in mental health service disciplines. The VA Health Care System is well positioned, as the largest trainer and employer of health service psychologists and other mental health professionals, to address the SUD training gap and serve as a leader in training the upcoming health care workforce. METHOD: To this end, we conducted two pilot studies to (1) examine the feasibility of implementing supplemental SUD training for VA health service trainees, among current VA mental health service providers in psychology, social work, and medical care (N = 37) and (2) the efficacy of a single 2-hour interdisciplinary SUD training seminar for VA health service trainees in mental health (N = 13). The training seminar consisted of several components including lecture, facilitated discussion, and role play, aimed at increasing trainee self-efficacy in assessing and diagnosing SUDs. RESULTS: Findings suggest that current providers are supportive of supplemental SUD training for VA trainees and believe that such training is beneficial for those wishing to pursue a career within the VA Health Care System. Additionally, results suggest that a single session didactic seminar improved trainees' self-reported efficacy in the assessment and referral of veterans diagnosed with SUDs. CONCLUSIONS: Overall, the above studies support additional feasibility investigations that would pave the way for successful implementation of widespread SUD training programs across the VA Health Care System and beyond. Successful implementation would then serve to reduce the increasingly critical SUD provider shortage, thus leading to significant public health gains.

Maladaptive Emotion Socialization as a Risk Factor for the Development of Negative Urgency and Subsequent Problem Drinking.

AIMS: Negative urgency, which refers to the tendency to act rashly when experiencing intense negative emotions, consistently serves as a robust predictor of problem drinking and other maladaptive behaviors. However, very little is known about the factors that influence the development of negative urgency itself. Although urgency theory suggests that environment and temperament interact to increase risk for the development of urgency, few studies, to date, have examined environmental risk for urgency. METHOD: In a cross-sectional sample of 518 adults recruited from Amazon Mturk, the current study began the investigation of the role of childhood maladaptive emotion socialization (MES) in risk for negative urgency and the possibility that negative urgency mediates the relationship between MES and problem drinking via self-report measures completed online. Data were analyzed using structural equation modeling. RESULTS: Individual differences in childhood MES, reported retrospectively, did predict increased present-day negative urgency. In addition, results were consistent with the possibility that negative urgency mediates the relationship between MES and problem drinking when considered concurrently with trait negative affect. CONCLUSIONS: Successful identification of early environmental predictors of negative urgency may provide useful targets for intervention efforts aimed at reducing or preventing the development of negative urgency and, subsequently, problem drinking. Further longitudinal investigations are needed to better examine these processes as they develop.

How people experience and respond to their distress predicts problem drinking more than does the amount of distress.

Although broad dispositional negative affect predicts problematic alcohol use, emerging evidence suggests that individual differences in how people experience and respond to negative affect may play an important role in risk. In a sample of 358 college students assessed twice across their first year of college, the current study investigated the predictive roles of trait negative affect, affective lability (the tendency to experience rapid and intense shifts in mood), negative urgency (the tendency to act rashly when highly emotional), and problem drinking via self-report measures completed online. Data were analyzed using structural equation modeling (SEM). Individual differences in how negative affect is experienced and responded to, represented by affective lability and negative urgency, predicted problem drinking above and beyond trait negative affect, and trait negative affect had no incremental predictive power. Additionally, affective lability predicted increases in negative urgency, but the opposite was not true. A focus on characteristic ways in which individuals experience and respond to negative affect, rather than negative affect itself, may improve risk assessment and clarify the etiology of problem drinking. Continued work toward the development of comprehensive affect-based risk models for problem drinking is needed.

Affect-Based Problem Drinking Risk: The Reciprocal Relationship between Affective Lability and Problem Drinking.

AIMS: Negative affect has been implicated in risk for the development of problematic drinking behavior. Furthermore, there is evidence for reciprocal relationships between negative affect and problem drinking, such that engagement in problem drinking also predicts increases in negative affect. However, affective models of risk often fail to consider affective lability-the experience of rapidly changing mood. Although affective lability appears to increase risk for problem drinking, it is unknown if this relationship persists above and beyond other affect-related constructs (e.g. depression, anxiety) and if it is reciprocal in nature. Accordingly, we used a longitudinal survey design to examine (a) if affective lability predicts problem drinking above and beyond depression and anxiety and (b) if affective lability and problem drinking demonstrate a reciprocal relationship. METHODS: First-year college students (n = 358) participated in a three wave longitudinal study. We constructed a structural equation model (SEM) of a random intercept cross-lagged panel model to test our hypotheses. RESULTS: Consistent with our hypotheses, affective lability predicted increases in problem drinking while anxiety and depression did not. Problem drinking and affective lability demonstrated a reciprocal relationship in which increases in one predicted increases in the other at subsequent time points. This relationship was present beyond the predictive effects of anxiety or depression. CONCLUSIONS: Affective lability appears to be an important affect-based predictor of problem drinking, and there may be a reciprocal, risk-enhancing relationship between affective lability and problem drinking.Components of negative affect, such as depression or anxiety, have been shown to predict risk for problem drinking, and vice versa. A less considered construct, affective lability, predicted problem drinking while anxiety and depression did not add any predictive power. Problem drinking and affective lability also appeared to demonstrate a reciprocal relationship.

Symptoms of anxiety, depression, and borderline personality in alcohol use disorder with and without comorbid substance use disorder.

OBJECTIVE: Alcohol use disorder (AUD) is highly comorbid with other substance use disorders (SUDs) as well as other psychiatric disorders, such as anxiety, depression, and Borderline Personality Disorder (BPD). However, studies of persons with AUD rarely account for its comorbidity with other SUDs. Some research suggests that BPD symptoms reflect an important connection between internalizing disorders and SUDs. The current study investigated: 1) the levels of trait anxiety and symptoms of depression and BPD in persons with an AUD as a function of comorbid SUDs (cannabis use disorder - CUD) and other substance use disorder (oSUD), and 2) the influence of BPD on the association between severity of overall lifetime SUD symptoms (AUD + CUD + oSUD) and both trait anxiety and symptoms of depression. METHOD: Trait anxiety and symptoms of depression and BPD were assessed in 671 young adults (351 men; 320 women; mean age 21 years) separated into four groups: Controls (n = 185), AUD-only (134), AUD + CUD (n = 210), and AUD + oSUD (n = 142). RESULTS: Trait anxiety and symptoms of depression and BPD were elevated in all AUD groups compared with controls, and in the AUD + oSUD group compared with all other groups as well. Structural models also indicated that BPD symptoms accounted for all of the variance in lifetime SUD symptoms associated with Trait Anxiety, and a significant portion of the variance in lifetime SUD symptoms associated with depression symptoms. CONCLUSION: Results indicate that when AUD is comorbid with oSUD, it is associated with more severe AUD symptoms and higher levels of trait anxiety and symptoms of both depression and BPD. The results also indicate that BPD symptoms account for the majority of the variance in SUD symptoms associated with both trait anxiety and depression, suggesting that a considerable amount of the internalizing symptomatology in AUD/SUDs is associated with BPD psychopathology.

The General Factor of Psychopathology.

An important advance in understanding and defining mental disorders has been the development of empirical approaches to mapping dimensions of dysfunction and their interrelatedness. Such empirical approaches have consistently observed intercorrelations among the many forms of psychopathology, leading to the identification of a general factor of psychopathology (the p factor). In this article, we review empirical support for p, including evidence for the stability and criterion validity of p. Further, we discuss the strong relationship between p and both the general factor of personality and the general factor of personality disorder, substantive interpretations of p, and the potential clinical utility of p. We posit that proposed substantive interpretations of p do not explain the full range of symptomatology typically included in p. The most plausible explanation is that p represents an index of impairment that has the potential to inform the duration and intensity of a client's mental health treatment.

Affective Risk for Problem Drinking: Reciprocal Influences Among Negative Urgency, Affective Lability, and Rumination.

BACKGROUND: Affective disturbances have long been implicated in the onset and maintenance of problematic alcohol use. Affective risk theory for problem drinking has moved beyond early documentation that negative affect broadly confers risk to models specifying specific affectbased risk processes. OBJECTIVE: This paper provides a theory-driven review of recent literature on the role of affect-based factors in the etiology of problematic alcohol use. First, we review recent advances in the understanding of affect-based risk for problem drinking. Second, we highlight the importance of three specific affect-based risk factors: urgency, affective lability, and rumination. Third, we offer hypotheses regarding the reciprocal relationships between specific risk factors and drinking problems. Finally, we suggest possible avenues for future research. CONCLUSION: Recent advances in the understanding of reciprocal prediction between affect-based risk factors and problem drinking have set the stage for important new avenues of investigation into the risk process. Affect-based risk processes appear to influence each otherover time, and they influence and are influenced by problem drinking. Further understanding of these processes will pave the way for a new generation of intervention strategies.

Sex Differences in Trait Anxiety's Association with Alcohol Problems in Emerging Adults: The Influence of Symptoms of Depression and Borderline Personality.

OBJECTIVE: The co-occurrence of alcohol use disorder (AUD) and internalizing psychopathology, such as anxiety and depression, has been well documented. However, most studies of the association between alcohol problems and anxiety, and do not simultaneously consider depression or borderline personality, which covary strongly with both anxiety symptoms and AUDs. The current study examined sex differences in the association between alcohol problems and anxiety, while accounting for depressive and borderline personality (BPD) symptoms. METHOD: A sample 810 (364 females) young adults aged 18-30 recruited from the community, who varied widely in lifetime alcohol problems, were administered diagnostic interviews and measures of a trait anxiety, depression, and BPD symptoms. RESULTS: Analyses revealed that trait anxiety, depression, and borderline symptoms were all significantly associated with higher lifetime alcohol problems in both males and females. However, the association between trait anxiety and alcohol problems was significantly stronger for males compared with females, even when controlling for depression and BPD symptoms. There were no significant sex differences in the association between alcohol problems and symptoms of either depression or BPD symptoms. CONCLUSION: This suggests specific sex differences in the mechanisms by which trait anxiety is associated with alcohol problems.