The impact of stay-at-home orders on vulnerability assessments and precautionary intentions during a pandemic.

In 2020, a novel emerging infectious disease - COVID-19 - became a global pandemic and prompted unprecedented social distancing measures. We examined the associations of voluntary stay-at-home (SAH) orders during the COVID-19 pandemic with vulnerability assessments and precautionary intentions (e.g. social distancing, hand washing). A quasi-experimental study using an online adult sample was conducted in U.S. states with and without voluntary SAH orders during the COVID-19 pandemic. Self-report surveys assessed vulnerability assessments and precautionary intentions. Participants living in states with SAH orders showed inflated vulnerability assessments for contracting COVID-19, and this association was stronger for affect-laden than cognitively-based assessments. Moreover, only affect-laden vulnerability assessments were uniquely associated with precautionary intentions and accounted for the relationship between SAH orders and precautionary intentions. Our study was among the first to explore the impact of voluntary SAH orders on vulnerability assessments and precautionary intentions. Results are discussed in terms of their implications for health behavioral models and applications for promoting self-protective actions during a pandemic.

Adherence to Social Distancing Guidelines Throughout the COVID-19 Pandemic: The Roles of Pseudoscientific Beliefs, Trust, Political Party Affiliation, and Risk Perceptions.

BACKGROUND: Adherence to COVID-19 social distancing guidelines varies across individuals. PURPOSE: This study examined the relations of pseudoscientific and just world beliefs, generalized and institutional trust, and political party affiliation to adherence to COVID-19 social distancing guidelines over three months, as well as the explanatory role of COVID-19 risk perceptions in these relations. METHODS: A U.S. nationwide sample of 430 adults (49.8% women; mean age = 40.72) completed a prospective online study, including an initial assessment (between March 27 and April 5, 2020), a 1 month follow-up (between April 27 and May 21, 2020), and a 3 month follow-up (between June 26 and July 15, 2020). We hypothesized that greater pseudoscientific and just world beliefs, lower governmental, institutional, and dispositional trust, and Republican Party affiliation would be associated with lower initial adherence to social distancing and greater reductions in social distancing over time and that COVID-19 risk perceptions would account for significant variance in these relations. RESULTS: Results revealed unique associations of lower governmental trust, greater COVID-19 pseudoscientific beliefs, and greater trust in the Centers for Disease Control and Prevention (CDC) to lower initial adherence to social distancing. Whereas greater COVID-19 risk perceptions and CDC trust were associated with less steep declines in social distancing over time, both Republican (vs. Democratic) Party affiliation and greater COVID-19 pseudoscientific beliefs were associated with steeper declines in social distancing over time (relations accounted for by lower COVID-19 risk perceptions). CONCLUSIONS: Results highlight the utility of public health interventions aimed at improving scientific literacy and emphasizing bipartisan support for social distancing guidelines.

Prospective interactive influence of financial strain and emotional nonacceptance on problematic alcohol use during the COVID-19 pandemic.

Background: Researchers have highlighted the risk for alcohol use problems in the context of COVID-19, although the factors associated with this risk remain unclear.Objectives: This study examined the prospective relation of baseline financial strain (reported at the beginning of the pandemic) to problematic alcohol use one month later, as well as the moderating role of emotional nonacceptance. We hypothesized that financial strain would be more strongly associated with problematic alcohol use one month later among participants with high (vs. mean or low) levels of nonacceptance.Methods: Shortly after COVID-19 was declared a pandemic by the WHO and national emergency by the U.S. President (on March 11 and 13, 2020, respectively), a U.S. nationwide community sample completed a prospective online study, including an initial assessment from March 27-April 5, 2020 and a one-month follow-up from April 27-May 21. Measures included the Family Economic Strain Scale, Difficulties in Emotion Regulation Scale, and Alcohol Use Disorders Identification Test. Participants included 254 adults reporting some alcohol use (50.4% women; mean age = 41.8).Results: Baseline financial strain was significantly positively associated with problematic alcohol use one month later only among participants with high (b =.06, SE =.03, p =.037) versus mean (b =.01, SE =.02, p =.677) or low (b = -.04, SE =.02, p =.110) emotional nonacceptance.Conclusion: Individuals experiencing financial strain in the context of COVID-19 may be at risk for problematic alcohol use if they are not accepting of their emotional distress.

The prospective influence of COVID-19 affective risk assessments and intolerance of uncertainty on later dimensions of health anxiety.

The COVID-19 pandemic is likely to increase risk for the development of health anxiety. Given that elevated health anxiety can contribute to maladaptive health behaviors, there is a need to identify individual difference factors that may increase health anxiety risk. This study examined the unique and interactive relations of COVID-19 affective risk assessments (worry about risk for contracting/dying from COVID-19) and intolerance of uncertainty to later health anxiety dimensions. A U.S. community sample of 364 participants completed online self-report measures at a baseline assessment (Time 1) and one month later (Time 2). Time 1 intolerance of uncertainty was uniquely associated with the Time 2 health anxiety dimension of body vigilance. Time 1 affective risk assessments and intolerance of uncertainty were uniquely associated with later perceived likelihood that an illness would be acquired and anticipated negative consequences of an illness. The latter finding was qualified by a significant interaction, such that affective risk assessments were positively associated with anticipated negative consequences of having an illness only among participants with mean and low levels of intolerance of uncertainty. Results speak to the relevance of different risk factors for health anxiety during the COVID-19 pandemic and highlight targets for reducing health anxiety risk.

Thwarted belongingness and perceived burdensomeness explain the associations of COVID-19 social and economic consequences to suicide risk.

OBJECTIVE: The social and economic consequences of COVID-19 and related public health interventions aimed at slowing the spread of the virus have been proposed to increase suicide risk. However, no research has examined these relations. This study examined the relations of two COVID-19 consequences (i.e., stay-at-home orders and job loss) to suicide risk through thwarted belongingness, perceived burdensomeness, and loneliness. METHOD: Online data from a nationwide community sample of 500 adults (mean age = 40) from 45 states were collected between March 27 and April 5, 2020. Participants completed measures assessing thwarted belongingness, perceived burdensomeness, loneliness, and suicide risk, as well as whether they (a) were currently under a stay-at-home order and (b) had experienced a recent job loss due to the pandemic. RESULTS: Results revealed a significant indirect relation of stay-at-home order status to suicide risk through thwarted belongingness. Further, whereas recent job loss was significantly correlated with suicide risk, neither the direct relation of job loss to suicide risk (when accounting for their shared relations to perceived burdensomeness) nor the indirect relation through perceived burdensomeness was significant. CONCLUSIONS: Results highlight the potential benefits of interventions targeting thwarted belongingness and perceived burdensomeness to offset suicide risk during this pandemic.

The Roles of Emotion Regulation Difficulties and Impulsivity in the Associations between Borderline Personality Disorder Symptoms and Frequency of Nonprescription Sedative Use and Prescription Sedative/Opioid Misuse.

Despite evidence of a strong relationship between BPD and substance use problems in general, little research has examined the associations of BPD symptoms with the misuse of sedatives or opioids, and no studies have explored possible factors that may underlie these associations. Thus, this study examined the relationships of BPD symptoms (i.e., the number of BPD criteria with threshold ratings on a diagnostic interview) to nonprescription sedative use, nonprescription opioid use, and prescription sedative/opioid misuse among 194 patients with alcohol and/or cocaine dependence in a residential substance use disorder treatment facility, as well as the roles of two theoretically-relevant factors in these relationships: emotion regulation (ER) difficulties and impulsivity facets. We found significant positive associations between BPD symptoms and nonprescription sedative use, nonprescription opioid use, and prescription sedative/opioid misuse. We also found significant positive indirect relationships of BPD symptoms to nonprescription sedative use through ER difficulties, ab = .04, 95% CI [.003, .09], and to prescription sedative/opioid misuse through two facets of impulsivity: lack of perseverance, ab = .05, 95% CI [.01, .11], and negative urgency, ab = .03, 95% CI [.002, .07]. Findings highlight the differential relevance of ER difficulties and impulsivity dimensions to the relationships of BPD symptoms to nonprescription sedative use and prescription sedative/opioid misuse, respectively, among patients with alcohol and/or cocaine dependence.

Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life.

The COVID-19 pandemic has resulted in the widespread implementation of extraordinary physical distancing interventions (e.g., stay-at-home orders) to slow the spread of the virus. Although vital, these interventions may be socially and economically disruptive, contributing to adverse psychological outcomes. This study examined relations of both stay-at-home orders and the perceived impact of COVID-19 on daily life to psychological outcomes (depression, health anxiety, financial worry, social support, and loneliness) in a nationwide U.S. community adult sample (N = 500; 47% women, mean age = 40). Participants completed questionnaires assessing psychological outcomes, stay-at-home order status, and COVID-19's impact on their daily life. Being under a stay-at-home order was associated with greater health anxiety, financial worry, and loneliness. Moreover, the perceived impact of COVID-19 on daily life was positively associated with health anxiety, financial worry, and social support, but negatively associated with loneliness. Findings highlight the importance of social connection to mitigate negative psychological consequences of the COVID-19 pandemic.

Examining posttraumatic stress disorder as a predictor of treatment response to dialectical behavior therapy.

OBJECTIVE: This study examined the presence of posttraumatic stress disorder (PTSD) as a predictor of treatment response to dialectical behavior therapy (DBT) across the primary outcomes of interest within DBT (i.e., borderline personality disorder [BPD] symptoms, deliberate self-harm, emotion regulation [ER] difficulties) and PTSD symptoms. METHOD: Participants (N = 56) were consecutive admissions to an outpatient DBT clinic that completed diagnostic interviews at intake and self-report outcome measures at intake and every 3 months throughout the treatment. RESULTS: Patients with (vs. without) a PTSD diagnosis did not report greater clinical severity at intake on most outcome measures, with the exception of PTSD symptom severity and, among older patients only, ER difficulties. The presence of a PTSD diagnosis was not associated with poorer treatment response to DBT. Instead, PTSD was associated with better response on the measure of BPD symptom severity. CONCLUSIONS: The results suggest that patients with PTSD can benefit from DBT.

Examining Relationships between Gender, Opioid Dependence, and Distress Tolerance among Patients in Substance Use Disorder Treatment.

Background: Opioid abuse/dependence is associated with multiple negative outcomes relative to other forms of substance abuse/dependence, including relapse. Research identifying modifiable characteristics associated with opioid dependence and associated negative outcomes may inform the development of targeted interventions for this high-risk population. One factor warranting investigation is low distress tolerance (DT). Purpose/Objectives: In a sample of patients in substance use disorder (SUD) treatment, the present study examined DT levels among patients with current opioid dependence versus no history of opioid dependence, as well as the moderating role of gender. We predicted that patients with opioid dependence would exhibit lower DT than those without a history of opioid dependence, and that women with opioid dependence would exhibit lower levels of DT than men with opioid dependence. Methods: A sample of 203 patients in residential SUD treatment were administered a series of diagnostic interviews and a behavioral measure of DT. Results: DT did not differ significantly as a function of opioid dependence. However, there was a significant opioid dependence by gender interaction, such that men with current opioid dependence exhibited significantly lower levels of DT than women with opioid dependence and men without a history of opioid dependence. Conclusions/Importance: Findings highlight a modifiable characteristic associated with opioid dependence among men that may be targeted in interventions.

Examining the impact of online rejection among emerging adults with borderline personality pathology: Development of a novel online group chat social rejection paradigm.

Borderline personality disorder (BPD) is characterized by emotional reactivity and interpersonal sensitivity, including greater emotional and cognitive reactivity to social rejection than controls. However, existing social rejection paradigms are not relevant to the particular social contexts that are increasingly relevant for adolescents and young adults (i.e., social media and online settings). This study examined emotional, parasympathetic, and cognitive responses to a novel online group chat social interaction task among emerging adults (18-24 years old) with a range of BPD pathology. Consistent with hypotheses, results revealed greater hostility and upset feelings, worse mood, greater threat to social needs, and greater respiratory sinus arrhythmia withdrawal in response to this task among participants in the rejection versus inclusion condition. Less support was found for the hypothesized relation of BPD pathology to greater reactivity to online social rejection. Specifically, although results revealed positive relations of BPD pathology with both negative mood in general and hostility in particular, in response to the task among participants in the rejection (but not inclusion) condition, the effect sizes associated with these findings were small, and the other hypothesized interactions of BPD pathology and group chat task condition were not significant. Conversely, results revealed associations of BPD pathology with greater threat to social needs and lower positive mood in response to the group chat task, regardless of condition. Results provide preliminary support for the utility of this novel online group chat rejection task for eliciting negative emotional, parasympathetic, and cognitive reactions in emerging adults with a range of BPD pathology. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Methods Matter: Nonsuicidal Self-Injury in the Form of Cutting is Uniquely Associated with Suicide Attempt Severity in Patients with Substance Use Disorders.

OBJECTIVE: Despite the robust relation between nonsuicidal self-injury (NSSI) and suicidal behaviors, there is considerable heterogeneity in NSSI characteristics that may have implications for the strength of the NSSI-suicide attempt relation. Past research highlights the relevance of both more severe NSSI methods and NSSI in the form of cutting in particular to suicide attempts. To further explore the relations of specific NSSI methods to suicide attempts, this study examined relations between different NSSI methods (i.e., those involving cutting, burning, blunt force, or resulting in minor tissue damage) and both overall suicide attempts and two indicators of suicide attempt severity (attempts requiring medical attention and nonambivalent attempts) in 203 substance-dependent patients in residential treatment. METHOD: Participants were administered questionnaires and semistructured interviews assessing the variables of interest. RESULTS: Cutting was the only NSSI method to demonstrate significant relations with overall suicide attempts, nonambivalent suicide attempts, and suicide attempts requiring medical attention. Results remained when considering relevant covariates. CONCLUSION: Results highlight an important link between NSSI methods involving cutting and suicide attempts among patients with substance use disorders. Findings also highlight the importance of more fine-grained characterizations of NSSI subgroups.

The Role of Opioid Use in Distinguishing between Suicidal Ideation and Attempts.

OBJECTIVE: Opioid use disorders are associated with heightened suicidal ideation, suicide attempts, and suicide death. This study aimed to examine the extent to which opioid differentiates between those with suicide attempts from those with lifetime suicidal ideation but no history of attempt. METHODS: Participants were drawn from the US National Guard and a residential substance use treatment facility. Multinomial logistic regression was utilized to determine the extent to which a lifetime history of nonmedical opioid use differentiated between (1) individuals with no lifetime history of suicidal ideation or attempt, (2) individuals with a history of suicidal ideation but no attempt, and (3) individuals with a history of at least one suicide attempt. RESULTS: History of opioid use among National Guard personnel and opioid use disorders among substance-dependent patients were associated with an increased likelihood of having at least one suicide attempt relative to both a history of suicidal ideation but no attempts and no history of ideation or attempts. Findings held when accounting for lifetime nonmedical use of other substances and the presence of other lifetime substance use disorders. CONCLUSIONS: Results highlight the importance of assessing for suicide risk among opioid users.

Multimodal assessment of emotional reactivity and regulation in response to social rejection among self-harming adults with and without borderline personality disorder.

Theories of borderline personality disorder (BPD) highlight the central role of emotional dysfunction in this disorder, with a particular emphasis on emotional reactivity and emotion regulation (ER) difficulties. However, research on emotion-related difficulties in BPD has produced mixed results, often related to the particular indices of emotional responding used in the studies. As such, the specific nature of emotional dysfunction in BPD, as well as the extent to which subjective emotion-related difficulties map onto corresponding physiological deficits, remains unclear. This study examined both subjective and physiological indices of emotional reactivity and ER difficulties in response to a social rejection emotion induction (relative to a neutral emotion induction) across three groups of participants: self-harming young adults with BPD, self-harming young adults without BPD, and clinical controls with no self-harm history or BPD. Consistent with the hypotheses, results revealed a lack of convergence between subjective and physiological indices of emotional reactivity and ER difficulties among participants with BPD. Whereas participants with BPD reported both greater emotional reactivity and greater ER difficulties in response to the negative emotion induction than participants without self-harm or BPD, there were no significant differences in physiological indices of emotional reactivity or ER between participants with BPD and either of the control groups. (PsycINFO Database Record (c) 2019 APA, all rights reserved).