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BACKGROUND: Prior studies indicate that neuroactive steroids mediate some of alcohol's effects. Dutasteride, widely used to treat benign prostatic hypertrophy, is an inhibitor of 5-alpha reductase enzymes, which play a central role in the production of 5α-reduced neuroactive steroids. The purpose of this study was to test dutasteride's tolerability and efficacy for reducing drinking. METHODS: Men (n = 142) with heavy drinking (>24 drinks per week) and a goal to either stop or reduce drinking to nonhazardous levels were randomized to placebo or 1 mg dutasteride daily for 12 weeks. We hypothesized that dutasteride-treated patients would be more successful in reducing drinking. RESULTS: Generalized linear mixed models that included baseline drinking, treatment, time and their 2-way interaction identified significant interactions of treatment-time, such that dutasteride treatment reduced drinking more than placebo. During the last month of treatment, 25% of dutasteride-treated participants had no hazardous drinking (no heavy drinking days and not more than 14 drinks per week) compared with 6% of placebo-treated participants (P = 0.006; NNT = 6). Sensitivity analysis identified baseline drinking to cope as a factor associated with larger reductions in drinking for dutasteride compared with placebo-treated participants. Dutasteride was well tolerated. Adverse events more common in the dutasteride group were stomach discomfort and reduced libido. CONCLUSION: Dutasteride 1 mg daily was efficacious in reducing the number of heavy drinking days and drinks per week in treatment-seeking men. The benefit of dutasteride compared with placebo was greatest for participants with elevated baseline drinking to cope motives.
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Inibidores de 5-alfa Redutase , Consumo de Bebidas Alcoólicas , Dutasterida , Humanos , Dutasterida/farmacologia , Dutasterida/administração & dosagem , Dutasterida/efeitos adversos , Masculino , Inibidores de 5-alfa Redutase/farmacologia , Inibidores de 5-alfa Redutase/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Pessoa de Meia-Idade , Consumo de Bebidas Alcoólicas/tratamento farmacológico , Adulto , Método Duplo-Cego , Resultado do Tratamento , Idoso , Azasteroides/farmacologia , Azasteroides/administração & dosagem , Azasteroides/uso terapêutico , Azasteroides/efeitos adversosRESUMO
Background: Recent evidence indicates that alcohol and other substance co-use, compared to alcohol-only use, might be more closely associated with negative reinforcement processes, and thus more likely during periods of increased stress. The present study examined this possibility by using data from an intensive longitudinal (daily) study of college student drinkers (N = 1461, 54% women). We also examined individual differences in coping and enhancement drinking motives as predictors of alcohol and other substance co-use. Results: We used multilevel multinomial logistic regression to predict, relative to alcohol-only days, the likelihood of alcohol co-use with either cigarettes or marijuana, along with alcohol use with multiple substances and other substance-only use from daily interpersonal and academic stress, day-of-the-week, sex, and individual differences in coping and enhancement drinking motives. We found that, relative to alcohol-only, alcohol and marijuana co-use was more likely, and non-alcohol related substance use was less likely, on weekends. Alcohol and marijuana co-use was less likely, and other substance-only use was more likely, on days characterized by greater academic stress, whereas alcohol and cigarette co-use was more likely on days characterized by greater interpersonal stress. Individuals with higher levels of drinking to cope motivation were more likely to engage in alcohol and cigarette co-use, other substance-only use, and alcohol plus multiple substances, relative to alcohol-only. Individuals with higher levels of enhancement motives were more likely to engage in all types of alcohol and other substance co-use and other substance-only use relative to alcohol-only. Conclusions: Findings are discussed in terms of the complex nature of different patterns of co-use patterns when evaluating indicators of positive- and negative-reinforcement processes.
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Fumar Maconha , Uso da Maconha , Transtornos Relacionados ao Uso de Substâncias , Humanos , Feminino , Masculino , Consumo de Bebidas Alcoólicas , Motivação , Adaptação Psicológica , UniversidadesRESUMO
INTRODUCTION: Cognitive dysfunction or deficits are common in patients with major depressive disorder (MDD). The current study systematically reviews and meta-analyzes multiple domains of cognitive impairment in patients with MDD. METHODS: PubMed/MEDLINE, PsycINFO, Cochrane Library, Embase, Web of Science, and Google Scholar were searched from inception through May 17, 2023, with no language limits. Studies with the following inclusion criteria were included: (1) patients with a diagnosis of MDD using standardized diagnostic criteria; (2) healthy controls (i.e., those without MDD); (3) neuropsychological assessments of cognitive impairment using Cambridge Neuropsychological Test Automated Battery (CANTAB); and (4) reports of sufficient data to quantify standardized effect sizes. Hedges' g standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) were used to quantify effect sizes of cognitive impairments in MDD. SMDs were estimated using a fixed- or random-effects models. RESULTS: Overall, 33 studies consisting of 2,596 subjects (n = 1,337 for patients with MDD and n = 1,259 for healthy controls) were included. Patients with MDD, when compared to healthy controls, had moderate cognitive deficits (SMD, -0.39 [95% CI, -0.47 to -0.31]). In our subgroup analyses, patients with treatment-resistant depression (SMD, -0.56 [95% CI, -0.78 to -0.34]) and older adults with MDD (SMD, -0.51 [95% CI, -0.66 to -0.36]) had greater cognitive deficits than healthy controls. The effect size was small among unmedicated patients with MDD (SMD, -0.19 [95% CI, -0.37 to -0.00]), and we did not find any statistical difference among children. Cognitive deficits were consistently found in all domains, except the reaction time. No publication bias was reported. CONCLUSION: Because cognitive impairment in MDD can persist in remission or increase the risk of major neurodegenerative disorders, remediation of cognitive impairment in addition to alleviation of depressive symptoms should be an important goal when treating patients with MDD.
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Disfunção Cognitiva , Transtorno Depressivo Maior , Testes Neuropsicológicos , Humanos , Transtorno Depressivo Maior/complicações , Disfunção Cognitiva/etiologiaRESUMO
Women who have experienced intimate partner violence (IPV) are disproportionately likely to engage in sexual risk behavior, including sex with a secondary partner (i.e., sex partners outside their primary relationship). Social disconnection has been identified as a social determinant of health that may enhance understanding of sex with a secondary partner. This study extends past research by using an intensive longitudinal design consisting of multiple daily assessments to examine event-level associations between women IPV survivors' social disconnection and sex with a secondary partner concurrently (i.e., during the same aggregated assessment) and temporally (i.e., social disconnection during one assessment predicting sex with a secondary partner in a subsequent assessment) over a 14-day period, in consideration of physical, psychological, and sexual IPV, and alcohol and drug use. Participants (N = 244) were recruited from New England through 2017. Results from multilevel logistic regression models indicate that women who experienced greater social disconnection on average were more likely to report sex with a secondary partner. However, after including IPV and substance use in the model, the strength of this relationship was attenuated. Sexual IPV emerged as a between-person predictor of sex with a secondary partner in temporally lagged models. Results provide insight into the relationships between daily social disconnection and sex with a secondary partner among IPV survivors, particularly regarding the effects of substance use and IPV both concurrently and temporally. Taken together, findings emphasize the importance of social connection for women's well-being and highlight the need for interventions that enhance interpersonal connectedness.
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Background: To examine whether individual differences in intensive longitudinal data-derived affective dynamics (i.e. positive and negative affect variability and inertia and positive affect-negative affect bipolarity) - posited to be indicative of emotion dysregulation - are uniquely related to drinking level and affect-regulation drinking motives after controlling for mean levels of affective states. Method: We used a large sample of college student drinkers (N = 1640, 54% women) who reported on their affective states, drinking levels and drinking motives daily for 30 days using a web-based daily diary. We then calculated from the daily data positive and negative affect variability, inertia, affect bipolarity and mean levels of affect and used these as predictors of average drinking level and affect-regulation drinking motives (assessed using both retrospective and daily reporting methods). Results: Findings from dynamic structural equation models indicated that mean levels of affect were uniquely related to drinking motives, but not drinking level. Few dynamic affect predictors were uniquely related to outcomes in the predicted direction after controlling for mean affect levels. Conclusion: Our results add to the inconsistent literature regarding the associations between affective dynamics and alcohol-related outcomes, suggesting that any effects of these indicators, after controlling for mean affect levels, might be more complex than can be detected with simple linear models.
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Adaptação Psicológica , Consumo de Bebidas Alcoólicas , Humanos , Feminino , Masculino , Consumo de Bebidas Alcoólicas/psicologia , Estudos Retrospectivos , Individualidade , Motivação , Afeto/fisiologia , UniversidadesRESUMO
OBJECTIVE: Research links approval-contingent self-worth to college drinking but has not differentiated social and solitary consumption. High approval-contingent self-worth individuals might drink socially to derive approval. METHOD: In a sample of 832 undergraduates, approval-contingent self-worth and drinking motives were measured in an initial questionnaire, and social and solitary consumption were reported daily for 30 days. RESULTS: Results indicated an overall positive association between approval-contingent self-worth and social consumption and positive indirect effects via social and enhancement motivations, but a negative indirect effect via conformity motivation. The association between approval-contingent self-worth and solitary alcohol consumption was nonsignificant because of a negative direct effect counteracted by a positive total indirect effect. CONCLUSIONS: Results highlight the importance of drinking motives and of distinguishing between social and solitary consumption.
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Consumo de Álcool na Faculdade , Motivação , Humanos , Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Social , Inquéritos e Questionários , Adaptação PsicológicaRESUMO
OBJECTIVE: To better understand how sleep is associated with alcohol consumption among college students, the present study tested whether last night's sleep duration and current day fatigue were associated with being around others who were drinking that night and, if so, with alcohol consumption. METHOD: College student drinkers (N = 540; mean age = 18.78 years; 52% female; 86% White) reported daily for 30 days yearly for up to 4 years on aspects of their sleep, their own alcohol use, and the perceived drinking of others in an intensive longitudinal burst design. RESULTS: Participants were less likely to report that they were with others who were drinking on evenings following higher than average sleep duration or greater than average daytime fatigue. In addition, experiencing greater than average daytime fatigue was associated with a lower likelihood of consuming any alcohol and lower levels of alcohol consumption at the daily level. Thus, daytime fatigue may be protective against alcohol consumption through both selection and behavior moderation. CONCLUSIONS: Results may be useful in the development of interventions to prevent heavy drinking among college students. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Consumo de Álcool na Faculdade , Duração do Sono , Humanos , Feminino , Adolescente , Masculino , Fadiga/epidemiologia , Etanol , Sono , Consumo de Bebidas Alcoólicas/epidemiologia , UniversidadesRESUMO
Existing data demonstrate reduced delta power during sleep in patients with depression and chronic pain. However, there has been little examination of the relationship between delta power and pain-reports, or pain-catastrophizing. We recruited female participants (n = 111) with insomnia and temporomandibular disorder, and measured nocturnal and daytime measures of pain and pain catastrophizing, and calculated relative nocturnal delta (0.5-4 Hz) power during sleep. We fit linear regression models, and further examined the moderating effect of depressive symptom severity. Lower relative delta power across the whole night was significantly associated with greater nocturnal pain (B = -20.276, P = .025, R2 = 0.214). Lower relative delta power during the first-third of the night, was associated with greater nocturnal pain (B = -17.807, p = 0.019, R2 = 0.217), next-day pain (B = 13.876, P = .039, R2 = 0.195), and next-morning pain (B = -15.751, P = .022, R2 = 0.198). Lower relative delta power during the final-third of the night was significantly associated with greater nocturnal (B = -17.602, P = .029, R2 = 0.207) and next-morning pain (3rd: B = -14.943, P = .042, R2 = 0.187). Depressive symptom severity did not moderate these relationships. Delta power was not significantly associated with nocturnal or daytime pain catastrophizing. These findings demonstrate that greater relative delta power during sleep is associated with lower nocturnal and next-day pain in patients with temporomandibular disorder. This data may guide the use of sleep interventions in clinical pain populations, with the aim of improving pain outcomes. PERSPECTIVE: This article presents data demonstrating an association between increased nocturnal delta power and reduced next-day pain. These findings may help promote interventions which aim to increase nocturnal delta power in clinical pain populations, with the goal of improving pain outcomes.
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Dor Crônica , Transtornos da Articulação Temporomandibular , Humanos , Feminino , Dor Crônica/complicações , Catastrofização , Transtornos da Articulação Temporomandibular/complicações , Sono , Articulação TemporomandibularRESUMO
OBJECTIVE: Social networks can be powerful determinants of drinking. Network Support (NS) treatment was designed to help persons with alcohol use disorder alter their social network to be more supportive of abstinence and less supportive of drinking. The present study was intended to determine how NS treatment altered behavior on a daily basis. It was expected that, relative to those treated in a packaged cognitive-behavioral treatment (PCBT), NS patients would report fewer daily contacts with drinking persons and increased contacts with nondrinking persons. METHOD: Patients (N = 193) treated in our second NS trial provided daily recordings of drinks consumed, urge to drink, and self-efficacy for not drinking, as well as reports of associations with drinking and nondrinking friends, via an interactive voice response system. Daily recordings (N = 146) were collected during the first 6 months of the 27-month study. Multilevel modeling was used to analyze daily network variables over time by treatment. Time-varying effect model (TVEM) analyses were also conducted to assess the influence of daily-varying social contacts on daily drinking, drinking urges, and self-efficacy. RESULTS: Consistent with hypotheses, NS patients reported significantly less daily drinking associated with contacts with drinkers than did PCBT patients. Patients in both treatments reported increases in self-efficacy and decreases in urges to drink over days as a function of contact with nondrinkers. CONCLUSIONS: NS treatment was successful in helping patients change their social networks, as well as their responses to social influences, and those changes had effects on day-to-day drinking levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Alcoolismo , Terapia Cognitivo-Comportamental , Humanos , Consumo de Bebidas Alcoólicas/terapia , Alcoolismo/terapia , Autoeficácia , Rede Social , Apoio SocialRESUMO
Stress has been linked to increased alcohol use but how stress may increase drinking in social drinkers is not well understood. Negative reinforcement processes may explain this link but the role of specific motivational processes, such as craving, and how these motivational processes are altered by drinking have not been studied. The current study assessed social drinkers (n = 81) for recent quantity and frequency of alcohol intake (quantity and frequency index, QFI) upon study enrollment, who then completed 30 days of electronic daily records of stress, craving, and alcohol intake. Multilevel structural equation models tested if person-averaged (between-person) and daily (within-person) craving mediated the link between stress and later drinking each evening and if recent quantity-frequency of drinking (QFI) moderated these associations. At the between-person level, both greater subjective stress, Est = .38, 95% confidence interval (CI) [.19, .57], and higher QFI predicted higher levels of craving, Est = .34, 95% CI [.20, .49]. Higher craving predicted more frequent drinking throughout the study, Est = .34, 95% CI [.01, .29]. At the within-person level, higher subjective stress predicted higher within-person craving; and the link between craving and later drinking was significant among those who had a higher QFI, Est = .84, 95% CI [.58, 1.12]. The subjective stress-drinking relationship was mediated by a greater alcohol craving response in social drinkers, and higher the QFI, greater the alcohol craving response. These results indicate that both higher levels of stress and greater recent alcohol intake patterns sensitize the craving response that in turn facilitates later alcohol intake. The findings suggest that higher recent alcohol use predict greater stress-potentiated initiation of drinking via higher craving responses. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Intoxicação Alcoólica , Fissura , Consumo de Bebidas Alcoólicas/epidemiologia , Fissura/fisiologia , Etanol , Humanos , Estudos ProspectivosRESUMO
OBJECTIVE: This study examined the dynamic, real-time associations between partner involvement in diabetes self-care and continuous glucose monitor (CGM) metrics in adults with type 2 diabetes. METHODS: For 1 week, 63 participants wore Dexcom G4 CGMs and provided momentary reports of partner involvement in diabetes self-care five times per day. Dynamic structural equation models were used to estimate the reciprocal lagged effects of partner involvement on next-hour CGM metrics (and vice versa). RESULTS: Partner involvement predicted improved next-hour glucose control for five of six CGM metrics in analyses adjusted for time-varying covariates. The hour after partner involvement, the model predicted a 26.34 mg/dl decrease in glucose level (standardized ß = -0.19), 30% greater odds of meeting target time in target range ( ß = 0.07), 48% higher odds of target time below target range (TBR; ß = 0.04; the only nonsignificant effect), 47% greater odds of target time above target range (ß = 0.11), a 4.20 unit decrease in glucose standard deviation ( ß = -0.19), and a 0.01 unit decrease in glucose coefficient of variation ( ß = -0.08; all p values < .05). There was less consistent support for the reverse pathway, with only two metrics significantly related to next-hour partner involvement: glucose level ( ß = 0.15) and TBR ( ß = 0.21), such that having higher levels and meeting target TBR were significantly predictive of next-hour partner involvement. CONCLUSIONS: This is the first study showing that partner involvement in daily diabetes management predicts short-term glucose control. More research is needed to understand how partners influence glycemic control and evaluate interventions that promote their involvement in diabetes care.
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Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Adulto , Glicemia/análise , Automonitorização da Glicemia , Diabetes Mellitus Tipo 2/terapia , Glucose , Hemoglobinas Glicadas/análise , Humanos , Hipoglicemiantes , AutocuidadoRESUMO
Objective: Drink offers are related to increased alcohol consumption, which is linked to sexual activity among college students. However, offers of alcohol may increase the odds of sexual activity that night independent of the amount of alcohol consumed. Participants: 540 undergraduate students were recruited for a longitudinal study of daily experiences. Method: Participants completed up to four annual waves of a measurement burst daily diary study. Using these longitudinal data, we examined whether receiving a drink offer on a given night was related to greater odds of having sex. Results: Receiving a drink offer (but not the number of drinks accepted) is related to greater odds of having sex, controlling for drinking level. Conclusions: Receiving a drink offer is uniquely related to odds of having sex when controlling for the amount of alcohol participants consumed. This may have implications for psychological functioning and relationship development.
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People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences-namely positive social experiences-that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (Nâ¯=â¯26) and a psychologically healthy control group (Nâ¯=â¯28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.
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Fobia Social , Adaptação Psicológica , Adulto , Consumo de Bebidas Alcoólicas , Ansiedade , Humanos , MotivaçãoRESUMO
ABSTRACT: Expectancies for pain and pain relief are central to experimental models of placebo analgesia and nocebo hyperalgesia and are a promising target for clinical intervention in patients with chronic pain. Affective states may play an important role in modulating the degree to which expectancies influence pain, broadening the opportunities for intervention targets. However, findings to date have been mixed and mostly limited to laboratory designs. Few studies have examined the interplay of naturally occurring affective states, pain expectancies, and pain experiences in the course of daily life with chronic pain. In this study, patients with temporomandibular disorder reported their daily pain expectancies and affective states each morning and their daily pain experience each evening, over a 2-week period. Multilevel modeling analyses revealed the association of morning pain expectancies with subsequent pain experiences was moderated by morning positive affective state ( B = 0.04, SE = 0.02, t = 2.00, P = 0.046) such that the congruent assimilation of a low pain expectancy with a low pain experience was starkest when morning positive affect was higher than usual. Relatedly, higher morning positive affect predicted greater odds of experiencing a match between pain expectancies and pain experience when the expectation was for low, but not high, pain levels (odds ratio = 1.19, confidence interval: 1.01-1.41, P = 0.03). Negative affect, in contrast, did not significantly influence the assimilation of high pain expectancies with high pain experiences. These findings extend previous experimental studies by showing that the association of daily pain expectancies with pain experience varies as a function of affective state.
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Dor Crônica , Dor Crônica/psicologia , Emoções , Humanos , Hiperalgesia , Efeito NoceboRESUMO
Emotion regulation and interpersonal psychotherapies that do not require trauma memory processing have been shown to be effective in treating posttraumatic stress disorder (PTSD). This study used a novel method to assess in vivo outcomes in a randomized clinical trial with women (N = 147; ages 18-54; 61% of color; 94% low income) with full (79%) or partial (21%) PTSD. Participants were assigned to affect regulation or interpersonal therapy, or wait-list, and completed daily self-reports for 2 to 4 weeks at baseline and up to 30 days at posttest. Mixed model regression analyses tested pre-post change on five factor analytically derived aggregated daily self-report scores. Emotion regulation-focused therapy was associated with reduced PTSD symptoms, dysregulation, and negative affect, and improvement in adaptive self-regulation and positive affect. Interpersonal-focused therapy was associated with reduced PTSD symptoms and dysregulation. Although both therapies were associated with reduced PTSD symptoms, whether this was due to nonspecific factors rather than the treatments per se could not be determined. Daily self-report data warrant further investigation in psychotherapy research with disorders such as PTSD, in order to assess affective and interpersonal dysregulation and adaptive regulation as they occur in daily life.
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Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Psicoterapia , Autorrelato , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto JovemRESUMO
OBJECTIVE: Systemic inflammation is commonly observed in idiopathic chronic pain conditions, including temporomandibular joint disorder (TMD). Trait positive affect (PA) is associated with lower inflammation in healthy controls, but those effects may be threatened by poor sleep. The associations between PA with proinflammatory cytokine activity and potential moderation by sleep in chronic pain are not known. We thus investigated the association between PA and circulating interleukin-6 (IL-6) and moderation of that association by sleep in a sample of women with TMD and sleep difficulties. METHODS: Participants (n = 110) completed the insomnia severity index and provided blood samples at five intervals throughout an evoked pain testing session. They then completed a 14-day diary assessing sleep and affect, along with wrist actigraphy. RESULTS: There was not a significant main effect of PA on resting or pain-evoked IL-6 (b = 0.04, p = .33). Diary total sleep time (b = -0.002, p = .008), sleep efficiency (b = -0.01, p = .005), sleep onset latency (b = 0.006, p = .010), and wake after sleep onset (b = 0.003, p = .033) interacted with PA to predict IL-6, such that PA inversely predicted IL-6 at higher levels of total sleep time and sleep efficiency and at lower levels of sleep onset latency and wake after sleep onset. Surprisingly, when sleep was poor, PA predicted greater IL-6. CONCLUSIONS: The potential salutary effects of PA on resting IL-6 erode when sleep is poor, underscoring the importance of considering sleep in conceptual and intervention models of TMD.
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Interleucina-6 , Distúrbios do Início e da Manutenção do Sono , Sono , Transtornos da Articulação Temporomandibular , Actigrafia , Feminino , Humanos , Interleucina-6/sangue , Sono/fisiologia , Distúrbios do Início e da Manutenção do Sono/sangue , Transtornos da Articulação Temporomandibular/sangueRESUMO
The majority of individuals with temporomandibular disorders (TMD) experience sleep disturbance, which can maintain and exacerbate chronic pain. However, the factors underlying the sleep-pain link have not been fully elucidated, especially beyond the laboratory. Sleep deprivation can induce threat interpretation bias, as well as impairment in positive affective functioning. Using both actigraphy and daily diaries, we examined whether morning pain expectancy and positive affect mediate the association between previous night's sleep disturbance and next-day overall pain severity. Total sleep time (TST) was selected as the primary measure of sleep. The sample included 144 women (mean age = 36 [SD = 11.1]) with TMD who displayed at least subclinical insomnia. Sleep was assessed for 14 days using actigraphy which was validated by concurrent sleep diaries. Daily diary assessments of pain-related experiences and affective states were conducted twice per day (ie, once upon participants' waking and the other prior to going to sleep) for the same 14-day period. Multilevel structural equation modeling revealed that both morning pain expectancy (95% CI: -.0004, -.00003) and positive affect (95% CI: -.0005, -.000001) mediated the association between previous night's TST and next-day's overall pain severity, such that shorter previous night TST was associated with higher next-morning pain expectancy and lower positive affect, which in turn were associated with a greater level of next-day's overall pain severity while controlling for morning pain severity. Reducing exaggerated daily pain expectancy and up-regulating positive affect may be important intervention targets for disengaging the sleep-pain link among individuals with co-occurring TMD and sleep disturbance. PERSPECTIVE: The daily link between previous night sleep duration and next day pain severity is mediated by morning pain expectancy and positive affect among women with temporomandibular disorder and sleep disturbance. Reducing pain expectancy and increasing positive affect may serve an important role in improving self-management of chronic pain.
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Dor Crônica , Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Transtornos da Articulação Temporomandibular , Actigrafia , Adulto , Dor Crônica/psicologia , Feminino , Humanos , Medição da Dor , Sono/fisiologia , Transtornos do Sono-Vigília/complicações , Transtornos da Articulação Temporomandibular/complicaçõesRESUMO
OBJECTIVES: We examined daily associations between drinking intentions and drinking behaviour and tested past drinking behaviour and current social environment as potential moderators of the daily intention-behaviour association. We expected both more frequent past drinking and being in a high drinking environment to weaken the intention-behaviour association. We also tested intentionality as a moderator of the association between alcohol consumption and next-day negative outcomes, expecting that less intentional alcohol consumption would be related to greater stress and regret. DESIGN: We tested these hypotheses using two separate micro-longitudinal studies of college students (Ns = 1,641, 540). METHODS: In two samples, participants completed bursts of data collection in which they indicated their previous alcohol consumption and then completed 30 days of diary surveys in which they reported their alcohol consumption and social environment the previous evening and their levels of stress, regret, and drinking intentions that day. RESULT: Consistent with our predictions, drinking intentions more strongly predicted drinking behaviour among individuals with less frequent past drinking behaviour, and, in Sample 1, drinking intentions more strongly predicted drinking behaviour among individuals in a low drinking environment. Contrary to hypotheses, results indicated that individuals with low drinking intentions were more likely to experience stress the next day, particularly if they consumed less alcohol. Greater consumption, however, was related to greater odds of experiencing regret, but this was stronger among individuals with higher drinking intentions. CONCLUSIONS: Findings are discussed in terms of the complex interplay between intentions and both social environment and contextual factors with respect to predicting drinking level and related problems.
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Consumo de Álcool na Faculdade , Intenção , Consumo de Bebidas Alcoólicas , Comportamentos Relacionados com a Saúde , Humanos , Estudantes , Inquéritos e Questionários , UniversidadesRESUMO
OBJECTIVE: The current study examined the unique influences of romantic relationship status and episodic and chronic stress associated with relationships in predicting changes in alcohol consumption and drinking motivations from college to post-college life. METHOD: Moderate to heavy college student drinkers reported their drinking level and drinking motives using an Internet-based daily diary for 30 days in college and again 5 years later. At the post-college wave, participants also completed a semi-structured phone-based interview to assess romantic relationship stress. RESULTS: Multiple regression analysis indicated that chronic relationship stress and relationship dissolution stress were uniquely related to mean daily levels of post-college drinking to cope (DTC) motivation, but not to mean daily levels of enhancement motivation. Some evidence was found for the effect of relationship status, but not stress, on mean daily heavy drinking levels. We also found evidence that chronic stress moderated the effect of relationship dissolution stress, with individuals showing higher mean daily chronic stress levels displaying a stronger positive association between relationship dissolution and post-college DTC motivation. CONCLUSIONS: Results are discussed in terms of how negative reinforcement processes might be an important mechanism underlying commonly found associations between romantic relationship status and problematic drinking during young adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Consumo de Álcool na Faculdade , Consumo de Bebidas Alcoólicas , Adaptação Psicológica , Adulto , Humanos , Motivação , Estudantes , Universidades , Adulto JovemRESUMO
Although many college students view drinking as a means of gaining a community and being social, research has not established whether alcohol consumption influences students' enjoyment and perceptions of how others view them or how this may differ based on the social or solitary nature of that consumption. The current study used online daily diary methods to examine the association between alcohol consumption and enjoyment and self-perceptions at the within- and between-person levels of analysis. Results indicated that undergraduate students (N=877; 52% female) enjoyed their evenings more when they consumed more than their typical number of drinks with others, but enjoyed evenings less when they consumed more than their typical number of drinks alone. In addition, consuming greater than their average number of drinks with others (but not alone) was related to feeling more social and attractive but less competent. These findings further highlight the distinct nature of social and solitary drinking and demonstrate positive outcomes of social alcohol consumption that may contribute to college alcohol consumption.