Engagement of pleasant activities in patients with substance use disorders: a correlational study.

BACKGROUND: There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients' involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pleasant activities. METHODS: Patients with SUDs (N = 265) were assessed at treatment entry on sociodemographic characteristics, primary type of substance (ie, alcohol or illicit drugs), addiction severity, craving, personality factors, and psychiatric distress. RESULTS: Regression analyses identified dissimilar predictor sets underlying frequency, enjoyability, and cross-product ratings, highlighting the multifaceted behavioral nature of activity engagement. Personality measures showed the strongest associations with patients' activity engagement, with extraversion as the key predictor. CONCLUSIONS: The present findings emphasize the complexity of patients' involvement in pleasant non-substance-related activities and further investigation is necessary to gain more insight into the underlying mechanisms of activity engagement.

Development and psychometric evaluation of the pleasant activities list.

This paper describes the development of a new 139-item behavioral questionnaire (PAL) assessing the frequency and enjoyability of pleasant activities occurring in the natural environment of patients with substance use disorders. The sample consisted of 265 patients with mainly substance use disorders and 272 healthy controls. Group comparisons indicated that patients reported lower frequency, enjoyability, and cross-product activity scores than controls. This study confirms previous findings that addiction is associated with a decreased level of engagement in pleasant activities. The PAL seems to be a standardized, feasible, and valid instrument to sample non-substance-related rewarding activities in patients' everyday lives.