An Integrative Review of Arts-Based Strategies for Addressing Pain and Substance Use Disorder During the Opioid Crisis.

In October 2017, the U.S. Department of Health & Human Services declared the opioid crisis a national public health emergency and prioritized identifying effective, evidence-based strategies for pain management and the prevention and treatment of substance use disorder (SUD). Increasingly, the arts have become more widely established and accepted as health-promoting practices in the United States and around the world. As the U.S. health care system moves toward greater integration of physical and behavioral health, arts-based interventions should be considered among potential complementary approaches for managing pain and preventing and treating SUD. We conducted an integrative literature review to summarize and synthesize the evidence on the role of the arts in the management of pain and in the prevention and treatment of SUD, including opioid use disorder. The available evidence suggests that music interventions may reduce participants' pain, reduce the amount of pain medication they take, improve their SUD treatment readiness and motivation, and reduce craving. Few studies examined art forms other than music, limiting the ability to draw conclusions for those art forms. Given the critical need to identify effective strategies for managing pain and preventing and treating SUD, future research on arts-based interventions should examine maintenance of pain management and SUD treatment benefits over time and outcomes related to SUD prevention.

Heterogeneity in the dynamic arousal and modulation of fear in young foster children.

Guided by emotional security theory, we explored how child and context-related factors were associated with heterogeneity in young foster children's organized patterns of fear response to distress. Results from group-based trajectory modeling used to analyze observational data from a fear-eliciting task showed that children from our sample (mean age = 62 months, SD = 9) were classified into 3 specific fear regulation patterns differentiated by the emotional response parameters of onset intensity, peak intensity, and rise time. A descriptive examination of child's emotion knowledge, aggressive behaviors, and attention problems, as well as length of time in current foster home, placement transitions, and caregiver responsiveness and modeling showed class-specific differences in means. Moreover, the likelihood of class membership was significantly predicted by children's emotion knowledge, aggressive behaviors, and foster mothers' responsiveness and modeling of appropriate boundaries. Results show promising support for the implementation of individualized, child-directed interventions targeting specific patterns of response parameters of emotion regulation for young foster children. Further, parenting intervention services need to promote the emotion socialization skills of foster parents that are tailored toward each specific trajectory pattern of emotion arousal and modulation.