Development and Psychometric Evaluation of a Brief Approach and Avoidance of Alcohol Questionnaire.

BACKGROUND: The Approach and Avoidance of Alcohol Questionnaire (AAAQ) was developed as a measure of craving to assess both desires to consume and desires to avoid consuming alcohol. Although the measure has been used in a variety of populations to predict future alcohol use behavior, the factor structures observed vary based on sample type (e.g., clinical vs. college samples) and may be overly long for use in repeated measures designs. The current article describes the development of a brief version of the AAAQ for use in clinical populations. METHODS: Using existing data sets of individuals in treatment for alcohol use disorder, exploratory analyses (e.g., exploratory factor analysis and item response theory) were conducted using an inpatient sample (N = 298) at a substance abuse treatment facility. Confirmatory analyses (e.g., confirmatory factor analysis and multiple regression) were conducted using an inpatient detoxification sample (N = 175) and a longitudinal outpatient treatment sample (N = 53). RESULTS: The brief AAAQ had comparable internal consistency, explained a similar amount of variance in alcohol consumption and related problems, and exhibited superior model fit as compared to the original measure. CONCLUSIONS: These findings indicate that the brief AAAQ is an effective tool to assess alcohol craving in clinical populations in treatment settings.

A standardised database of Chinese emotional film clips.

Film clips are widely used in emotion research due to their relatively high ecological validity. Although researchers have established various film clip sets for different cultures, the few that exist related to Chinese culture do not adequately address positive emotions. The main purposes of the present study were to establish a standardised database of Chinese emotional film clips that could elicit more categories of reported positive emotions compared to the existing databases and to expand the available film clips that can be used as neutral materials. Two experiments were conducted to construct the database. In experiment 1, 111 film clips were selected from more than one thousand Chinese movies for preliminary screening. After 315 participants viewed and evaluated these film clips, 39 excerpts were selected for further validation. In experiment 2, 147 participants watched and rated these 39 film clips, as well as another 8 excerpts chosen from the existing databases, to compare their validity. Eventually, 22 film excerpts that successfully evoked three positive emotions (joy, amusement, and tenderness), four negative emotions (moral disgust, anger, fear, and sadness), and neutrality formed the standardised database of Chinese emotional film clips.

Two Studies of Connectedness to Parents and Suicidal Thoughts and Behavior in Children and Adolescents.

We tested hypotheses that greater connectedness to parent(s) is associated with lower risk for nonlethal suicidal thoughts and behavior (STB), termed direct protective effects, and that parent connectedness serves to moderate (lower) the risk for STB associated with psychopathology including major depressive episode (MDE), termed moderating protective effects. Independent samples of children and adolescents recruited for a multicenter study of familial alcoholism were studied. Generalized estimating equation models were used that adjusted for age, sex, and youth psychopathology variables. The sample for Study 1 was assessed at baseline and about 2- and 4-year follow-ups, with baseline characteristics of n = 921, M age = 14.3 ± 1.8 years, and 51.8% female. The sample for Study 2 was assessed at baseline and about 5-year follow-up, with baseline characteristics of n = 867, M age = 12.0 ± 3.2 years, and 51.0% female. In both studies, increased perceived connectedness to father but not mother was associated with lower risk for measures of STB, consistent with direct protective effects. In Study 1, measures of parent connectedness were associated with lower risk for STB but only for youth that did not experience MDE (or alcohol use disorder), inconsistent with moderating protective effects. Study 2 showed that connectedness to fathers was associated with lower risk for suicide plans or attempts (severe STB) but not frequent thoughts of death or dying (nonsevere STB). Improved connectedness to fathers may lower risk for STB in children and adolescents, consistent with direct protective effects. Hypotheses about moderating protective effects were not supported.

The Indirect Effect of Peritraumatic Dissociation on the Relationship Between Childhood Maltreatment and Schizotypy.

Schizotypy is a multidimensional personality construct that is understood as a vulnerability for schizophrenia, often manifesting as more subtle and attenuated symptoms, referred to as schizotypic psychopathology. It has many well-established environmental risk factors, including experiencing childhood maltreatment (CM), but the intermediary mechanisms that relate CM to schizotypic psychopathology are unclear. Prior studies have demonstrated that trait dissociation may indirectly affect the relationship between CM and schizotypic psychopathology. However, less is known about the importance of peritraumatic dissociative experiences during CM and how it relates to schizotypic symptom manifestations in young adulthood. Therefore, the present study explored the independent contributions of peritraumatic and trait dissociation in the relationship between CM and schizotypy. Participants (N = 346) were undergraduate students who completed online self-report measures on CM, trait dissociation, peritraumatic dissociation experienced during CM, and schizotypic symptoms. The indirect effect of peritraumatic dissociation and trait dissociation on the relationship between CM and schizotypy was examined using mediational analyses. Correlational analyses revealed significant associations between self-reported CM, schizotypy, trait dissociation, and peritraumatic dissociation. In addition, mediational analyses indicated a significant indirect effect of peritraumatic dissociation (ß = .06, 95% confidence interval (CI) [0.01, 0.12]), but not trait dissociation (ß = .05, 95% CI [-0.02, 0.12]), on CM and schizotypy. These results highlight peritraumatic dissociation as an important mechanism driving the expression of schizotypic symptoms among individuals with a history of CM. Understanding how trauma sequelae lead to schizotypic psychopathology may be crucial in assessing and treating individuals with maltreatment histories or those on the psychosis spectrum.

Alcohol use during the COVID-19 pandemic: gender, parenthood, intimate partner violence, and stress.

Some preliminary work during the COVID-19 pandemic indicates that adult alcohol use increased, particularly for parents. This cross-sectional study examined the quantity and frequency of adults' alcohol use during the early stages of the pandemic. Additionally, the influences of gender, parenthood, COVID-19-related stressors and intimate partner violence (IPV) on alcohol consumption were examined. The sample consisted of 298 adults (98 parents) from across the United States who completed self-report surveys through Qualtrics at the beginning of the pandemic in May 2020. In the present study, all men reported higher levels of drinking compared to all women. Although stress levels did not impact alcohol consumption, findings indicate that increased IPV experiences were associated with higher levels of heavy drinking during the pandemic. Results also suggested that having children in the home particularly impacted drinking levels during the pandemic, above and beyond the influence of gender, IPV, and stress levels. These findings suggest that parenthood may have had a cascading influence on drinking experiences during the COVID-19 pandemic. Implications and recommendations for further research are discussed.

GABRA2 genotype, impulsivity, and body mass.

BACKGROUND: The goal of this study was to test a hypothesis associating impulsivity with an elevated body mass index (BMI). METHODS: To this end, we examined associations of BMI with putative genetic, neurophysiological, psychiatric, and psychological indicators of impulsivity in 78 women and 74 men formerly dependent on alcohol or drugs. A second analysis was designed to test the replicability of the genetic findings in an independent sample of 109 women and 111 men with a similar history of substance dependence. RESULTS: The results of the first analysis showed that BMI was positively correlated with Total and Nonplanning Scale Scores on the Barratt Impulsiveness Scale and the number of childhood symptoms of Attention-Deficit/Hyperactivity Disorder in women. It was also positively correlated, in women, with a GABRA2 variant previously implicated as a risk factor for substance dependence and an objective electroencephalographic feature previously associated with GABRA2 and relapse risk. The second analysis confirmed that the correlation between BMI and the substance-dependence-associated GABRA2 genotype was reliable and sex-specific. CONCLUSIONS: We conclude that an elevated BMI is associated with genetic, neurophysiological, psychiatric, and psychological indicators of impulsivity. The sex difference may be explained by greater opportunities to eat and overeat, a preference for higher calorie foods, a longer duration of alcohol/drug abstinence, or previous pregnancies in women.

Psychopathy and axis I psychiatric disorders among criminal offenders: relationships to impulsive and proactive aggression.

Both psychopathology and aggression are heterogeneous constructs. Determining which forms of psychopathology relate to risk for different classes of aggressive behavior has implications for risk recognition and management. This study examined the relationships of impulsive aggression (IA) and proactive aggression (PA) to psychopathy and symptoms of several Diagnostic and Statistical Manual Axis I disorders in a sample of criminal offenders. Results replicated prior findings from community samples of a broad relationship between psychopathology and IA. PA was related only to psychopathy. An interaction was found whereby IA was associated with impulsive-antisocial traits of psychopathy only for individuals with moderate to high levels of generalized anxiety. Results indicate that assessing and treating several Axis I disorders in offenders may decrease risk for IA. Moreover, current findings raise the possibility that generalized anxiety is a key, modifiable component of the relationship between IA and impulsive-antisocial traits.

Comparison of impulsive and premeditated perpetrators of intimate partner violence.

Violence occurs in four to five million intimate relationships each year in the United States. Past research has investigated the concept of batterer subtypes based on the nature of the violent behavior. To extend this research, the present study used the Impulsive/Premeditated Aggression Scale (IPAS) along with a battery of relevant self-report measures in a sample of men (N = 113) convicted of domestic violence and court ordered into an intervention program. Batterers whose violence was classified as premeditated scored higher on psychopathic traits and a measure of treatment rejection. Batterers whose violence was classified as impulsive in nature reported a wider range of serious psychopathology. It is suggested that the use of a bimodal classification (Impulsive/Premeditated) in batterers may have significant clinical and legal policy implications.

Event-Related Potentials as Biomarkers of Behavior Change Mechanisms in Substance Use Disorder Treatment.

Substance use disorders (SUDs) are one of the most prevalent psychiatric conditions and represent a significant public health concern. Substantial research has identified key processes related to reinforcement and cognition for the development and maintenance of SUDs, and these processes represent viable treatment targets for psychosocial and pharmacological interventions. Research on SUD treatments has suggested that most approaches are comparable in effectiveness. As a result, recent work has focused on delineating the underlying mechanisms of behavior change that drive SUD treatment outcome. Given the rapid fluctuations associated with the key neurocognitive processes associated with SUDs, high-temporal-resolution measures of human brain processing, namely event-related potentials (ERPs), are uniquely suited to expand our understanding of the underlying neural mechanisms of change during and after SUD treatment. The value of ERPs in the context of SUD treatment are discussed along with work demonstrating the predictive validity of ERPs as biomarkers of SUD treatment response. Example associations between multiple ERP components and psychosocial and/or pharmacological treatment outcome include the P3a and P3b (in response to neutral and substance-related cues), the attention-related negativities (e.g., N170, N200), the late positive potential, and the error-related negativity. Also addressed are limitations of the biomarker approach to underscore the need for research programs evaluating mechanisms of change. Finally, we emphasize the advantages of ERPs as indices of behavior change in SUD treatment and outline issues relevant for future directions in this context.

Alcohol use moderates the relationship between symptoms of mental illness and aggression.

Diagnosis of mental illness (MI) inconsistently predicts aggressive behavior although co-occurrence of substance use appears to increase the frequency of aggression in MI populations. We propose that alcohol use should moderate the relationship between mental disorders marked by deficits in self-control and aggression and victimization. In the present study, alcohol use, physical aggression perpetration, physical aggression victimization, injury and psychiatric symptoms were assessed in a sample of 297 substance use disorder patients (102 women; Mage = 38.9, SD = 20.2) recruited from a residential treatment facility. Negative binomial regression analyses examined the relationship of physical aggression, victimization, and injury over the previous 12 months to symptoms of bipolar mania, psychosis, posttraumatic stress disorder, antisocial personality disorder (ASPD), and daily volume of alcohol consumed. Consistent with past research relating MI to aggression, rates of victimization were higher than rates of perpetration. Results demonstrated that alcohol use moderated the relationship of manic symptoms of bipolar disorder to perpetration of aggression and causing injury to others. Three way-interactions between gender, alcohol use, and both psychotic and ASPD symptoms were related to victimization. The combination of heavy alcohol use and increased psychotic or ASPD symptoms was related to greater victimization for women but not for men. Women with more psychotic symptoms who were heavy drinkers were also more likely to report causing injury to another person. Results were generally consistent with the multiple-thresholds model of alcohol-related aggression; however, the moderating effects of alcohol use were dependent on gender and type MI. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Alcohol, Self-Regulation and Partner Physical Aggression: Actor-Partner Effects Over a Three-Year Time Frame.

The question of how individual differences related to self-regulation interact with alcohol use patterns to predict intimate partner aggression (IPA) is examined. We hypothesized that excessive drinking will be related to partner aggression among those who have low self-regulation. In addition, we explored the extent to which differences in self-regulation in one partner may moderate the relationship between alcohol use and partner aggression. A sample of married or cohabitating community couples (N = 280) ages 18-45 was recruited according to their classification into four drinking groups: heavy drinking in both partners (n = 79), husband only (n = 80), wife only (n = 41), by neither (n = 80), and interviewed annually for 3 years. IPA, drinking, and scores on measures of negative affect, self-control, and Executive Cognitive Functioning (ECF) were assessed for both members of the couple. The Actor Partner Interdependence Model (APIM) was used to analyze longitudinal models predicting the occurrence of IPA from baseline alcohol use, negative affect, self-control and ECF. Actor self-control interacted with partner self-control such that IPA was most probable when both were low in self-control. Contrary to prediction, actors high in alcohol use and also high on self-control were more likely to engage in IPA. Partner alcohol use was predictive of actor IPA when the partner was also high in negative affect. Low partner ECF was associated with more actor IPA. These findings suggest that self-regulatory factors within both members of a couple can interact with alcohol use patterns to increase the risk for relationship aggression.

Reliability of the Impulsive-Premeditated Aggression Scale (IPAS) in treated opiate-dependent individuals.

The purpose of the study was to evaluate the internal consistency and test-retest reliability of the Impulsive Aggression (IA) and Premeditated Aggression (PM) scales of the Impulsive-Premeditated Aggression Scale (IPAS) in male and female substance-dependent patients, and to compare the findings to those obtained on widely used, validated measures of aggression. Using a sample of 121 patients (61 women) in methadone maintenance treatment, 69 (35 women) of which were re-evaluated after a minimum of 2weeks, the IPAS scales showed acceptable internal consistency (alpha>.72) and test-retest reliability (ICC>.54). These results were comparable to the other aggression measures, and results among women were comparable to men. This was the first study to examine the IPAS scales in a substance use population, to contain a sufficient sample of women for sub-analyses, and to examine the stability of the measure. Findings support the internal consistency and test-retest reliability of the IPAS in male and female opiate-dependent individuals.

Drinking and driving behavior at stop signs and red lights.

Alcohol is one of the principal risk factors for motor vehicle crashes. One factor that contributes to vehicle crashes is noncompliance with stop signs and red lights. The present experiment investigated the effects of alcohol and drinking patterns on driving behavior at stop signs and red lights. 28 participants participated in drinking and simulated driving sessions during which they received a moderate dose of alcohol (0.08% BAC) or a placebo. Simulated driving tasks measured participants' driving performance at stop signs and red lights in response to each dose. Results suggested that alcohol impaired the driver control of speed and direction and prolonged their simple and complex reaction time, which were exhibited by impaired speed and lateral control, longer reaction time when the lights turned yellow, and lower deceleration towards stop signs and red lights. Visual degradation may also occur under alcohol intake. It was also suggested that alcohol impaired non-binge drinkers more severely. To be specific, higher acceleration was observed in impaired non-binge drinkers.

(Dis)similarity in Impulsivity and Marital Satisfaction: A Comparison of Volatility, Compatibility, and Incompatibility Hypotheses.

Impulsivity is negatively associated with relationship satisfaction, but whether relationship functioning is harmed or helped when both partners are high in impulsivity is unclear. The influence of impulsivity might be exacerbated (the Volatility Hypothesis) or reversed (the Compatibility Hypothesis). Alternatively, discrepancies in impulsivity might be particularly problematic (the Incompatibility Hypothesis). Behavioral and self-report measures of impulsivity were collected from a community sample of couples. Mixed effect polynomial regressions with response surface analysis provide evidence in favor of both the Compatibility Hypothesis and the Incompatibility Hypothesis, but not the Volatility Hypothesis. Mediation analyses suggest results for satisfaction are driven by perceptions of the partner's negative behavior and responsiveness. Implications for the study of both impulsivity and relationship functioning are discussed.

Borderline personality disorder features in adolescent girls: P300 evidence of altered brain maturation.

OBJECTIVE: To examine brain maturation in adolescent girls with borderline personality disorder (BPD) features using the P300 event-related potential. METHODS: One hundred twenty-three girls, aged 14-19 yrs, were assigned to one of 4 groups formed by the crossing of BPD features (vs. > or =5 BPD criteria) and median age (vs. >16.5 yrs). P300 responses were measured while subjects performed a complex visual oddball task. RESULTS: ANCOVAs of P300 amplitude-adjusting for variability associated with comorbid conduct disorder and depression symptoms--revealed a significant interaction. Among subjects without BPD features, aging was associated with the normal reduction in visual P300 amplitude. Among subjects with BPD features, there were no age-related changes. Additional analyses, which tested the effects of BPD features across the full age range, supported these findings. CONCLUSIONS: The present findings suggest abnormal brain maturation among adolescent girls exhibiting features of BPD. SIGNIFICANCE: These results support a hypothesis of altered brain maturation in adolescents exhibiting BPD features at an early age. It is suggested that measures of brain maturation obtained during adolescence may improve our ability to predict BPD and comorbid disorders in adulthood.

Electrophysiological substrates of impulsiveness: potential effects on aggressive behavior.

Previous investigations attempting to examine impulsiveness as a personality construct are likely confounded with a high incidence of aggressive and antisocial behavior. The present study assessed electroencephalographic activity at rest and during photic stimulation in two groups: (1) an impulsive group (n=10) scoring high on the Barratt Impulsiveness Scale (BIS-11) and reporting no indication of impulsive aggressive behavior; and (2) a non-aggressive control group (n=14) scoring within the normal range on the BIS-11. All subjects completed a brief battery of personality measures related to impulsivity and aggression. Resting EEG was recorded at 9 electrode sites. Photic stimulation was administered at three frequency levels. The primary findings were consistently lower frontal delta and theta activity in the impulsive group as well as a different topographical pattern of beta activity between the groups. These differences appeared to be independent of photic stimulation. Personality analyses indicated significantly greater hostility and lifetime history of aggression in the impulsive group. Taken together, the personality and EEG results suggest some similarity between the present impulsive group and research on groups regularly exhibiting premeditated aggression. These results provide unique insight into the construct of impulsivity and its role in the expression of specific subtypes of aggressive behavior.

N400 as an index of semantic expectancies: differential effects of alcohol and cocaine dependence.

BACKGROUND: Chronic substance abuse has been associated with decrements in the processing and expression of language. The present study utilized the N400 event-related electroencephalographic potential to index semantic processing in 133 adults with (n=49) or without (n=84) a history of alcohol and/or cocaine dependence. The contributions of age, gender, and comorbid marijuana and nicotine dependence, and antisocial symptomology to N400 decrements were either covaried or controlled. METHODS: A continuous series of 300 stimuli was presented for 150 ms each (interstimulus interval=1475 ms) on a computer screen. The series was arranged such that a word (approximately 17% of stimuli) immediately preceded presentations of its antonym (primed condition; approximately 17% of stimuli), or a semantically unrelated word (unprimed condition; approximately 17% of stimuli). The remaining 50% of stimuli consisted of unpronounceable letter combinations (non-word condition). EEG responses to the antonyms, unrelated words, and letter jumbles were retained for analysis. Throughout the task, the subject pressed response keys to discriminate words from non-words. RESULTS: Analyses revealed a detrimental effect of alcohol dependence on N400 amplitude and no significant main or interactive effects of cocaine dependence. CONCLUSION: The present findings suggest that alcohol-dependent individuals may exhibit verbal processing decrements. These findings also challenge hypotheses suggesting that the combined use of cocaine and alcohol is more deleterious to brain function than alcohol use alone.

A comparison of anticonvulsants in the treatment of impulsive aggression.

This study compared the behavioral effects of 3 anticonvulsants in impulsive aggressive men. In a double-blind, placebo-controlled, parallel groups design, participants were randomly assigned to 1 of 4 6-week treatments: phenytoin (n = 7), carbamazepine (n = 7), valproate (n = 7), or placebo (n = 8). The efficacy measure was the average aggression score, a global severity index from the Overt Aggression Scale (J. M. Silver & S. C. Yudofsky, 1991). Analysis showed a significant reduction in impulsive aggression during all 3 anticonvulsant conditions compared with placebo. However, the treatment effect during carbamazepine administration was slightly delayed compared with phenytoin and valproate. These findings suggest that increased use of anticonvulsants could make a significant impact in the control of impulsive aggression in both mental health and criminal justice settings.

Psychometric Evaluation of the Substance Use Risk Profile Scale (SURPS) in an Inpatient Sample of Substance Users Using Cue-Reactivity Methodology.

The current project sought to examine the psychometric properties of a personality based measure (Substance Use Risk Profile Scale; SURPS: introversion-hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) designed to differentially predict substance use preferences and patterns by matching primary personality-based motives for use to the specific effects of various psychoactive substances. Specifically, we sought to validate the SURPS in a clinical sample of substance users using cue reactivity methodology to assess current inclinations to consume a wide range of psychoactive substances. Using confirmatory factor analysis and correlational analyses, the SURPS demonstrated good psychometric properties and construct validity. Further, impulsivity and sensation-seeking were associated with use of multiple substances but could be differentiated by motives for use and susceptibility to the reinforcing effects of stimulants (i.e., impulsivity) and alcohol (i.e. sensation-seeking). In contrast, introversion-hopelessness and anxiety sensitivity demonstrated a pattern of use more focused on reducing negative affect, but were not differentiated based on specific patterns of use. Taken together, results suggests that among those receiving inpatient treatment for substance use disorders, the SURPS is a valid instrument for measuring four distinct personality dimensions that may be sensitive to motivational susceptibilities to specific patterns of alcohol and drug use.

P300 evidence of cognitive inflexibility in female adolescents at risk for recurrent depression.

Studies utilizing the P300 event-related potential (ERP) to document potential neurophysiological deficits related to depression have produced variable findings. The present investigation examined the effects of two tasks to determine whether one task would be more sensitive to a history of depression. We examined 124 female subjects, aged 14-20 years. Each subject was assigned to either a history of depression (DEP-Hx) or control group based on the presence versus absence of a DSM-III-R Major Depressive Episode. ERPs were recorded during two auditory oddball tasks. The first task was a simple two-pitch auditory discrimination and the second task was a three-stimulus auditory discrimination. In both tasks, subjects responded to the same rare target tone. Analysis of P300 amplitudes indicated a significant group by task interaction. Simple effects indicated that control subjects exhibited smaller target P300 amplitudes during the three-stimulus task as compared to the two-stimulus task. In contrast, subjects with a history of depression did not show a significant difference in P300 target amplitude between the two tasks. These results suggest that depression history as well as task difficulty/modality may influence the utility of the P300 in documenting the neurophysiological aspects of depression.