Comorbid Substance Use Disorder Profiles and Receipt of Substance Use Disorder Treatment Services: A National Study.

OBJECTIVE: Those with comorbid substance use disorders (SUDs) are a particularly vulnerable group. Information regarding the nature of these comorbidities and how they relate to receipt of substance use treatment could reduce the treatment gap that exists among those with comorbid SUDs. METHOD: Public-use data from the 2015-2017 National Surveys on Drug Use and Health was used to analyze past-year SUD comorbidity combinations among 12 substances and the relationship between these combinations with past-year treatment in adults (N = 128,740). RESULTS: In all, 7.9% of adults had at least one SUD in the past year (6.7% had one SUD, 0.9% had two SUDs, and 0.3% had three or more). Conditioning on specific SUDs, the prevalence of having additional SUDs ranged from 14.9% (alcohol) to 85.1% (hallucinogens). The four most common SUD combinations all included alcohol use disorder. Alcohol and marijuana use disorder was the most common comorbidity combination and had the lowest receipt of treatment. Compared to those with one SUD, adjusted odds of receiving treatment were almost two times greater for those with two SUDs, and more than four times greater for those with three or more SUDs. Treatment prevalence was lower for those who had higher family income and education, were not employed full time, were married, were younger than age 26 years or older than age 50 years, and were Asian. CONCLUSIONS: Even though the treatment gap is reduced among those with multiple SUDs, it remains large. The most common and undertreated comorbid SUD combinations, in conjunction with the most underserved groups, could be targeted to facilitate treatment uptake.

Exploring power in response inhibition tasks using the bootstrap: The impact of number of participants, number of trials, effect magnitude, and study design.

A primary psychometric concern with laboratory-based inhibition tasks has been their reliability. However, a reliable measure may not be necessary or sufficient for reliably detecting effects (statistical power). The current study used a bootstrap sampling approach to systematically examine how the number of participants, the number of trials, the magnitude of an effect, and study design (between- vs. within-subject) jointly contribute to power in five commonly used inhibition tasks. The results demonstrate the shortcomings of relying solely on measurement reliability when determining the number of trials to use in an inhibition task: high internal reliability can be accompanied with low power and low reliability can be accompanied with high power. For instance, adding additional trials once sufficient reliability has been reached can result in large gains in power. The partial dissociation between reliability and power was particularly apparent in between-subject designs where the number of participants contributed greatly to power but little to reliability, and where the number of trials contributed greatly to reliability but only modestly (depending on the task) to power. For between-subject designs, the probability of detecting small-to-medium-sized effects with 150 participants (total) was generally <55%. However, effect size was positively associated with number of trials. Thus, researchers have some control over effect size and this needs to be considered when conducting power analyses using analytic methods that take such effect sizes as an argument. Results are discussed in the context of recent claims regarding the role of inhibition tasks in experimental and individual difference designs.

Inhibition tasks are not associated with a variety of behaviors in college students.

Executive functioning (EF) is defined as a set of top-down processes used in reasoning, forming goals, planning, concentrating, and inhibition. It is widely believed that these processes are critical to self-control and, therefore, that performance on behavioral task measures of EF should be associated with individual differences in everyday life outcomes. The purpose of the present study was to test this core assumption, focusing on the EF facet of inhibition. A sample of 463 undergraduates completed five laboratory inhibition tasks, along with three self-report measures of self-control and 28 self-report measures of life outcomes. Results showed that although most of the life outcome measures were associated with self-reported self-control, only one of the outcomes was associated with inhibition task performance at the latent-variable level, and this association was in the unexpected direction. Furthermore, few associations were found at the individual task level. These findings challenge the criterion validity of lab-based inhibition tasks. More generally, when considered alongside the known lack of convergent validity between inhibition tasks and self-report measures of self-control, the findings cast doubt on the task's construct validity as measures of self-control processes. Potential methodological and theoretical reasons for the poor performance of laboratory-based inhibition tasks are discussed.

Temporal dynamics of reactive cognitive control as revealed by event-related brain potentials.

Reactive cognitive control refers to a complementary set of cognitive operations by which individuals monitor for and detect the presence of goal-interfering conflict (i.e., conflict monitoring/evaluation) and, subsequently, initiate attention-focusing and response selection processes to bolster goal-directed action in the face of such conflict (regulative control). The purpose of the current study was to characterize the nature of conflict adaptation in both components of this dynamic process across sequences of trials and, more broadly, across time as participants complete a cognitive control task. Fifty-two young adults completed a standard arrow flanker task while behavioral and ERP data were recorded. Multilevel modeling of sequences of compatible and incompatible trials over time showed that, whereas response time data demonstrated a typical conflict adaptation effect throughout the task, N2 and frontal slow wave (FSW) indices of conflict monitoring and regulative control, respectively, demonstrated significant conflict adaptation only during the early part of the task. Moreover, although differential change in N2 and FSW over time suggested that conflict monitoring and regulative control were dissociable, a reciprocal relation between them was maintained throughout the task and was not present in a component theoretically unrelated to conflict adaptation (visual attention-related N1). Findings are discussed in terms of compensatory processes that help to maintain goal-directed performance even as control-related neural responses become fatigued.

Associations between executive functioning, affect-regulation drinking motives, and alcohol use and problems.

Motivation to use alcohol to regulate positive and negative affect and deficits in cognitive control (i.e., executive functions [EFs]) have both been associated with increased alcohol involvement and alcohol-related consequences. Although dual-process models predict that affect-driven motivations and cognitive control should interact to determine alcohol involvement and alcohol-related consequences, this intersection has remained largely unexplored. The present study examined the extent to which effects of enhancement and coping drinking motives on alcohol use, heavy drinking, and alcohol-related consequences are moderated by individual differences in three theorized components of EF. We anticipated, in general, that drinking motives would more strongly predict alcohol use, heavy drinking, and alcohol-related consequences among individuals low versus high in cognitive control-EF. Participants (N = 801) completed a battery of nine EF tasks, as well as measures of drinking motives, alcohol use, heavy drinking, and alcohol-related negative consequences. A baseline structural model indicated that (a) both enhancement motives and coping motives predicted alcohol use and heavy drinking, (b) both enhancement and coping motives exerted their effects on alcohol-related consequences both directly and indirectly via alcohol use, and (c) shifting-specific abilities were modestly positively associated with heavy drinking. Most important for the aims of the study, latent variable interaction analyses failed to provide consistent evidence that better EF abilities attenuate the effects of drinking motives on alcohol use, heavy drinking, and alcohol-related consequences, as predicted. (PsycINFO Database Record

Using ERPs to investigate valence processing in the affect misattribution procedure.

The construct validity of the affect misattribution procedure (AMP) has been challenged by theories proposing that the task does not actually measure affect misattribution. The current study tested the validity of the AMP as a measure of affect misattribution by examining three components of the ERP known to be associated with the allocation of motivated attention. Results revealed that ERP amplitudes varied in response to affectively ambiguous targets as a function of the valence of preceding primes. Furthermore, differences in ERP responses to the targets were largely similar to differences in ERPs elicited by the primes. The existence of valence differentiation in both the prime-locked and the target-locked ERPs, along with the similarity in this differentiation, provides evidence that the affective content of the primes is psychologically registered, and that this content influences the processing of the subsequent, evaluatively ambiguous targets, both of which are required if the priming effects found in the AMP are the result of affect misattribution. However, the behavioral priming effect was uncorrelated with ERP amplitudes, leaving some question as to the locus of this effect in the information-processing system. Findings are discussed in light of the strengths and weaknesses of using ERPs to understand the priming effects in the AMP.

Separate and joint effects of alcohol and caffeine on conflict monitoring and adaptation.

RATIONALE: Caffeine is commonly believed to offset the acute effects of alcohol, but some evidence suggests that cognitive processes remain impaired when caffeine and alcohol are coadministered. OBJECTIVES: No previous study has investigated the separate and joint effects of alcohol and caffeine on conflict monitoring and adaptation, processes thought to be critical for self-regulation. This was the purpose of the current study. METHODS: Healthy, young adult social drinkers recruited from the community completed a flanker task after consuming one of four beverages in a 2 × 2 experimental design: Alcohol + caffeine, alcohol + placebo caffeine, placebo alcohol + caffeine, or placebo alcohol + placebo caffeine. Accuracy, response time, and the amplitude of the N2 component of the event-related potential (ERP), a neural index of conflict monitoring, were examined as a function of whether or not conflict was present (i.e., whether or not flankers were compatible with the target) on both the previous trial and the current trial. RESULTS: Alcohol did not abolish conflict monitoring or adaptation. Caffeine eliminated conflict adaptation in sequential trials but also enhanced neural conflict monitoring. The combined effect of alcohol and caffeine was apparent only in how previous conflict affected the neural conflict monitoring response. CONCLUSIONS: Together, the findings suggest that caffeine leads to exaggeration of attentional resource utilization, which could provide short-term benefits but lead to problems conserving resources for when they are most needed.