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Objective: Emergent research suggests that trauma-exposed Latinx college students are a particularly at-risk group for eating-related problems. For this reason, there is a need to further understand the cognitive processes that may underpin maladaptive eating among this vulnerable segment of the population. Participants: Participants included 304 trauma exposed Latinx college students (84.5% females; Mage = 22.8 years, SD = 5.79). Methods: The current study examined the role of mindful attention in relation to several distinct expectancies related to eating. Results: Results indicated that lower reported levels of mindful attention were associated with greater levels of expectancies of eating to help manage negative affect, expectancies that eating will alleviate boredom, and expectancies that eating will lead to feeling out of control. Conclusions: These findings suggest that it may be beneficial to assess for mindful attention among Latinx college students with a history of trauma exposure presenting with problematic eating behaviors.
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Emoções , Estudantes , Feminino , Humanos , Adulto Jovem , Adulto , Masculino , Estudantes/psicologia , Universidades , Comportamento Alimentar/psicologia , Hispânico ou LatinoRESUMO
Cannabis use disorder (CUD) is the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. Integrated cannabis and anxiety reduction treatment (ICART) was developed based on translational research; it integrates a transdiagnostic CBT for anxiety disorders with MET/cognitive behavior therapy (MET-CBT) for CUD, with outcomes comparable to MET-CBT alone. The current study tested whether ICART is more efficacious than MET-CBT alone for patients with more severe baseline cannabis use and use-related problems. Individuals seeking treatment for CUD (56.4% male, Mage = 23.2, 63.3% non-Hispanic White) with at least one comorbid anxiety disorder were randomly assigned to ICART (n = 27) or MET-CBT (n = 28). Baseline severity of cannabis use and use-related problems moderated the relation between condition and posttreatment outcomes, such that among patients with the greatest baseline cannabis use, ICART was associated with less posttreatment cannabis use than MET-CBT alone. Further, among those with the greatest number of cannabis-related problems, patients in ICART reported fewer posttreatment problems than those in the MET-CBT alone condition. These data suggest that for dually diagnosed patients with more severe cannabis use, ICART may be more efficacious than a gold-standard psychosocial CUD treatment, MET-CBT. MET-CBT may be more efficacious for those with less baseline cannabis use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Abuso de Maconha/complicações , Abuso de Maconha/terapia , Adulto , Transtornos de Ansiedade/diagnóstico , Comorbidade , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Abuso de Maconha/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Insomnia symptoms may be an important etiological factor for substance use disorders; however, whether improving sleep leads to reductions in problematic substance use among at-risk populations remains unclear. METHOD: As such, the current pilot study used a randomized controlled design to test the effects of Brief Behavioral Treatment for Insomnia (BBTI) against a waitlist control among a sample of trauma-exposed young adults with elevated insomnia symptoms who regularly use cannabis (N = 56). RESULTS: Intent-to-treat multilevel modeling analyses indicated that BBTI may be more efficacious than waitlist control in reducing self-reported insomnia symptoms, with large effects three months post-treatment (d = 1.34). Further, our initial evidence suggested that BBTI resulted in reductions in cannabis-related problems with medium to large effects at three months post-treatment (d = 0.75). The current pilot analyses indicated BBTI also reduced cravings to use cannabis to reduce negative emotions in response to trauma cues with a large effect size. CONCLUSION: This pilot study suggests BBTI may be efficacious not only in improving insomnia symptoms among cannabis users but also in reducing cannabis-related problems and cravings over three months. Future research should replicate these results in a larger, fully powered sample with improved follow-up rates designed to test temporal mediation using multimethod assessments of insomnia symptoms and problematic cannabis use. Overall, BBTI may be a promising intervention for trauma-exposed cannabis users to improve sleep and reduce cannabis-related problems.
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Cannabis , Distúrbios do Início e da Manutenção do Sono , Terapia Comportamental/métodos , Humanos , Projetos Piloto , Distúrbios do Início e da Manutenção do Sono/terapia , Resultado do Tratamento , Adulto JovemRESUMO
Third wave cognitive and behavioral therapies have garnered significant attention in the study and treatment of addiction. Such treatments employ a process-oriented, transdiagnostic approach to mitigate problematic thought and behavioral patterns and consequences associated with substance use. Although initial evidence is promising, much remains unknown regarding the impact of third wave processes on substance use behavior and treatment outcomes. Additionally, more work is needed to elucidate the potential of novel third wave treatments on substance use outcomes. If proven successful, third wave processes and therapies may hold the key to disrupt the huge financial, societal, and personal burden associated with addiction. This Special Issue highlights recent, scientifically rigorous, clinically applicable advances in current understanding of third wave cognitive and behavioral processes and therapies for substance use. Research presented in this Special Issue covers topics ranging from the role and application of mindfulness in the etiology of substance use behavior, treatment outcomes, and familial support; the potential of transdiagnostic factors as important considerations for vulnerable groups; and the development and refinement of novel technological and integrated interventions. This Special Issue is organized into three parts classified as third wave processes and substance use behavior; third wave processes in traditional substance use treatment and their malleability; and third wave treatments for substance use among special populations. It is hoped that this issue will alert readers to the significance of this work, illustrate the many domains currently being explored via process-oriented, transdiagnostic treatment, and identify promising and impactful areas for research.
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Comportamento Aditivo , Atenção Plena , Transtornos Relacionados ao Uso de Substâncias , Comportamento Aditivo/terapia , Cognição , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia , Resultado do TratamentoRESUMO
INTRODUCTION: Combustible tobacco smoking and cannabis use frequently occur together, and the use of both substances is associated with overall greater severity of tobacco and cannabis related problems. Observational work has found that cannabis use is associated with tobacco cessation failure, but research directly testing the longitudinal associations of cannabis use on tobacco cessation during smoking cessation treatment is lacking. The current study examined the impact of current cannabis use on combustible tobacco cessation outcomes. METHODS: 207 daily combustible tobacco smokers (Mage = 38.24 years, SD = 14.84, 48.1 % male) were enrolled in a randomized controlled smoking cessation trial. Survival analyses and multi-level modeling were used to assess lapse and relapse behavior through 12-week follow up. The current study is a secondary data analysis. RESULTS: Results of the current study suggest that cannabis use is associated with faster time to lapse (OR = 0.644, se = .188, p = .019), but not relapse (OR = -0.218, se = .403, p = .525), compared to combustible tobacco-only smokers. Additionally, cannabis use was associated with lower likelihood of achieving any 7-day point prevalence abstinence during the 12 week follow up (b = 0.93, se = 0 0.24, p = 0.0001). CONCLUSIONS: The current study provides novel evidence that cannabis use may be related to combustible tobacco use in terms of faster time to lapse and lower likelihood of any 7-day point prevalence abstinence following smoking cessation treatment. Developing integrated cannabis-tobacco cessation treatments is an important next step in research focused on tobacco-cannabis use.
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Fumar Cigarros/psicologia , Fumar Cigarros/terapia , Fumar Maconha/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Adulto , Fumar Cigarros/epidemiologia , Fumar Cigarros/tendências , Feminino , Humanos , Masculino , Fumar Maconha/epidemiologia , Fumar Maconha/tendências , Pessoa de Meia-Idade , Estudos Prospectivos , Autorrelato , Abandono do Hábito de Fumar/métodos , Adulto JovemRESUMO
Research to date provides striking evidence that youth from low socio-economic status (SES) households are at an increased risk for smoking. Converging evidence from developmental studies, psychopathology studies, intervention studies, and basic research on self-control abilities have identified working memory and distress tolerance as potential crucial modifiable risk factors to prevent smoking onset in this cohort. To confirm the value of these mechanistic targets, this randomized trial was designed to evaluate the influence of working memory and distress tolerance interventions on risk of smoking initiation. Recruiting primarily from low-income community afternoon programs, we randomized 93 adolescents to one of three intervention conditions, all of which were a prelude to a smoking-prevention informational intervention: (1) a working memory intervention, (2) a mindfulness training intervention to target distress tolerance, and (3) a wellness-focused control condition. Despite a number of adherence efforts, engagement in treatment was limited, and under these conditions no significant evidence was found either for differential efficacy for smoking prevention or for intervention effects on mechanistic targets. However, working memory capacity and distress tolerance were found to be negatively related to smoking propensity. As such, our mechanistic targets-working memory and distress tolerance--may well be processes undergirding smoking, despite the fact that our interventions did not adequately engage these targets.
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Regulação Emocional , Memória de Curto Prazo , Atenção Plena , Prevenção do Hábito de Fumar/métodos , Fumar/psicologia , Adolescente , Boston , Criança , Desvalorização pelo Atraso , Feminino , Humanos , Masculino , Projetos Piloto , Pobreza , Angústia Psicológica , Classe SocialRESUMO
OBJECTIVES: Trauma exposure and obesity are highly prevalent among college students and both are associated with disordered eating. There is a need to understand psychological factors that may be related to maladaptive eating behavior among college students with obesity and a history of trauma exposure. METHODS: Participants included 139 college students with obesity (defined as a BMI ≥ 30) and a history of trauma exposure (76.3% females; M age = 25.4 years, SD = 8.07). The current study conducted three separate two-step hierarchical regressions examining mindful attention, and its relation to eating expectancies (expectancies of eating to help manage negative affect, expectancies of eating to alleviate boredom, and expectancies of eating to lead to feeling out of control). RESULTS: Results indicated that lower levels of mindful attention were related to greater levels of expectancies of eating to help manage negative affect (b = -4.16, SE = 1.08, p = .023, CI95% = -7.72, -0.60, sr2 = .04), expectancies of eating to alleviate boredom (b = -1.09, SE = 0.39, p = .006, CI95% = -1.86, -0.32, sr2 = .06), and expectancies of eating to lead to feeling out of control (b = -1.62, SE = 0.40, p < .001, CI95% = -2.41, -0.83, sr2 = .11). Results were observed over, and above variance accounted for by sex (assigned at birth), body mass index (BMI), and posttraumatic stress disorder (PTSD) symptom severity. CONCLUSIONS: Overall, the results from the present investigation suggest the potential importance and need for future research in the role of mindful attention in relation to several distinct eating expectancies associated with maladaptive eating.
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INTRODUCTION: Despite negative effects of smoking, smokers have difficulty quitting, suggesting a need for additional strategies to help them quit. A single-session hatha yoga intervention acutely reduced craving among nicotine-deprived smokers not attempting to reduce or quit, yet it is unknown if it reduces craving among those attempting to change their smoking. Thus, this study tested the efficacy of a single-session hatha yoga intervention for acutely reducing craving among smokers attempting to reduce or quit smoking. METHODS: Data presented are part of a larger dissertation project. Participants were 55 community-recruited smokers (62% male) motivated to reduce or quit smoking randomized to one session of hatha yoga (n = 25) or wellness control (ie, reading educational materials about healthy lifestyle; n = 30) on their intervention day (ie, the day on which they began to reduce or quit smoking). Participants rated, "I have a desire for a cigarette right now," on a 7-point Likert scale immediately before and after the intervention. RESULTS: After statistically controlling for CO in breath, participant type, age, gender, race, and ethnicity, a significant Time × Condition interaction was found, F(1, 47) = 4.72, p = .035, ηp2 = .09, suggesting craving decreased at a greater rate in the hatha yoga condition relative to the wellness condition. CONCLUSIONS: Results from this study add to a growing body of research demonstrating the potential clinical utility of hatha yoga as an adjunctive intervention tool for smoking cessation. IMPLICATIONS: This is the first known study to test the impact of a single-session hatha yoga intervention on craving among adult smokers attempting to reduce or quit smoking. We found that 30 minutes of hatha yoga produced a greater reduction in craving compared to a 30-minute wellness control condition. This relationship was evident even after statistically accounting for other important variables (eg, gender). Results of this study add to a growing body of literature demonstrating the potential clinical utility of hatha yoga as an adjunctive intervention strategy for smoking cessation.
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Fissura , Smartphone/estatística & dados numéricos , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Fumar/terapia , Yoga , Adolescente , Adulto , Idoso , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Adulto JovemRESUMO
Cannabis use disorder (CUD) is the most common illicit substance use disorder and individuals with CUD have high rates of comorbid anxiety disorders. Comorbidity between CUD and anxiety disorders is of public health relevance given that although motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, outcomes are worse for patients with elevated anxiety. The current study tested the acceptability and efficacy of the integration of a transdiagnostic anxiety CBT (i.e., treatment of patients with any anxiety disorder) with MET-CBT (integrated cannabis and anxiety reduction treatment, or ICART) for CUD compared to MET-CBT alone. Treatment-seeking cannabis users (56.4% male, Mageâ¯=â¯23.2, 63.3% non-Hispanic White) with CUD and at least one comorbid anxiety disorder were randomly assigned to ICART (nâ¯=â¯27) or MET-CBT (nâ¯=â¯28). Patients in the ICART condition attended significantly more treatment sessions than those in the MET-CBT condition. Patients in the ICART condition were more likely to be abstinent post-treatment than those in MET-CBT. Further, treatment produced decreases in cannabis use and related problems. Notably, therapy type did not moderate the impact of treatment on frequency of use and related problems. Together, these data suggest that ICART may be at least as efficacious as a gold-standard psychosocial CUD treatment, MET-CBT, for a difficult-to-treat subpopulation of cannabis users.
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Transtornos de Ansiedade/terapia , Uso da Maconha/terapia , Adolescente , Adulto , Transtornos de Ansiedade/psicologia , Terapia Cognitivo-Comportamental , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Uso da Maconha/psicologia , Projetos Piloto , Resultado do Tratamento , Adulto JovemRESUMO
The present study examined the moderating role of mindful attention in the relation between experiential avoidance and anxious arousal, social anxiety, depressive symptoms, and the number of mood and anxiety disorders among a sample of Latinos seeking health services at a primary care facility. Participants included 326 adult Latinos (Mageâ¯=â¯39.79 years, SDâ¯=â¯11.27; 88.9% female; 98.2% used Spanish as their first language). Results provided empirical evidence of an interaction between mindful attention and experiential avoidance for anxious arousal, social anxiety, depressive symptoms, and the number of mood and anxiety disorders in the studied sample. Specifically, among Latinos with lower (vs higher) levels of mindfulness, greater experiential avoidance was related to greater anxiety/depressive symptoms and number of mood and anxiety disorders. Together, these data provide novel empirical evidence of the clinically relevant interplay between mindful attention and experiential avoidance regarding a relatively wide array of negative emotional symptoms and disorders among Latino primary care patients. Limitations of the study include a largely female sample and cross-sectional data.
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Transtornos de Ansiedade/etnologia , Atenção , Aprendizagem da Esquiva , Depressão/etnologia , Transtorno Depressivo/etnologia , Hispânico ou Latino/psicologia , Atenção Plena , Adulto , Ansiedade/diagnóstico , Ansiedade/etnologia , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Estudos Transversais , Depressão/diagnóstico , Depressão/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Primária à Saúde , Sudoeste dos Estados UnidosRESUMO
PURPOSE: Literature has documented the prevalence of anxiety and its adverse effect on quality of life among patients with breast cancer from Western countries, yet cross-cultural examinations with non-Western patients are rare. This cross-cultural study investigated differences in anxiety and its association with quality of life between US and Chinese patients with breast cancer. METHODS: Patients with breast cancer from the United States and China completed measures for anxiety (Spielberger State-Trait Anxiety Inventory) and quality of life (Functional Assessment of Cancer Therapy-Breast). RESULTS: After controlling for demographic and medical characteristics, Chinese patients reported higher levels of trait and state anxiety than US patients. Although there was an association between anxiety and quality of life in both groups of patients, the association between state anxiety and quality of life was stronger among Chinese patients than among US patients, with the association between trait anxiety and quality of life the same between the two cultural samples. CONCLUSION: These findings suggest that anxiety and its association with quality of life among patients with breast cancer varies depending on cultural context, which reveals greater anxiety and poorer quality of life among Chinese patients compared with US patients. This suggests greater unmet psychosocial needs among Chinese patients and highlights the need to build comprehensive cancer care systems for a better quality of life in Chinese populations.
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Ansiedade/etnologia , Ansiedade/psicologia , Neoplasias da Mama/etnologia , Neoplasias da Mama/psicologia , Adulto , China , Comparação Transcultural , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Estados UnidosRESUMO
Anxiety sensitivity (AS)- fear of anxiety symptoms and their potential negative consequences-has been implicated in the development of substance use problems and motivation to use substances for coping with distress, though the AS components (physical, cognitive, and social concerns) have not been studied extensively in relation to alcohol- and cannabis-related variables. In a cross-sectional design, self-report measures of AS and alcohol and cannabis use, motives, and problems were administered to 364 treatment-seeking cigarette smokers with a history of alcohol and cannabis use. In both adjusted and unadjusted analyses, linear regression models indicated that AS cognitive concerns are related to cannabis-use conformity motives, alcohol-use coping motives, and alcohol problems; AS physical and cognitive concerns are related to greater cannabis problems specifically in males; and AS social concerns are associated with greater social, coping, enhancement, and conformity drinking motives. AS cognitive and physical concerns were also related to greater alcohol and cannabis problems, respectively, in subsamples limited to 214 current alcohol users and 170 current cannabis users. Together with prior work, current findings suggest that it may be beneficial to focus more on addressing AS cognitive concerns in individuals with tobacco-alcohol problem comorbidity, whereas it may be beneficial to focus on addressing both AS physical and cognitive concerns in males with tobacco-cannabis problem comorbidity. In addition, cigarette smokers high in AS social concerns may benefit from relaxation training to lessen their social anxiety as well as behavioral activation to enhance their positive affect.
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Consumo de Bebidas Alcoólicas/psicologia , Transtornos de Ansiedade/psicologia , Abuso de Maconha/psicologia , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Adaptação Psicológica , Adulto , Ansiedade/diagnóstico , Ansiedade/psicologia , Transtornos de Ansiedade/diagnóstico , Comorbidade , Correlação de Dados , Feminino , Humanos , Masculino , Abuso de Maconha/diagnóstico , Abuso de Maconha/reabilitação , Pessoa de Meia-Idade , Psicometria , Facilitação Social , Inquéritos e QuestionáriosRESUMO
Pain problems are of significant public health concern, and with opioid-related problems and death due to overdose at an all-time high, there is significant public health importance to identify risk factors that link instances of pain to opioid misuse among persons with pain whether or not they have been prescribed opioids for pain management. Severe pain and pain-related problems have been associated with increased risk for opioid misuse, and recent research indicates that pain-related anxiety (worry about the negative consequences of pain) may contribute to a more debilitating pain experience. Additionally, pain-related anxiety has previously been linked to substance use motives and dependence for cannabis and tobacco. However, little research has examined pain-related anxiety as a transdiagnostic risk factor for opioid misuse. The current study examined the relationship between pain-related anxiety and self-reported opioid misuse (addiction, prescription denial, family concerns, detox) in a racially/ethnically diverse sample of young adults (N = 256, M age = 22.84) reporting moderate to severe bodily pain over the previous four weeks. Results indicated that pain-related anxiety was significantly related to several indicators of opioid misuse as well as an increased number of opioid-related problems. Findings from the current study suggest that targeting pain-related anxiety may be one therapeutic strategy to reduce opioid misuse.
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Analgésicos Opioides/uso terapêutico , Ansiedade/psicologia , Dor Crônica/psicologia , Transtornos Relacionados ao Uso de Opioides/psicologia , Uso Indevido de Medicamentos sob Prescrição , Adolescente , Adulto , Ansiedade/etiologia , Dor Crônica/complicações , Dor Crônica/tratamento farmacológico , Feminino , Humanos , Masculino , Transtornos Relacionados ao Uso de Opioides/complicações , Manejo da Dor , Fatores de Risco , Autorrelato , Adulto JovemRESUMO
BACKGROUND: Mindfulness (or "Mindful Attention") has been described as the presence or absence of attention to, and awareness of, what is occurring in the present moment. Among smokers, greater mindfulness is associated with greater effect stability and reduced cue-induced craving. While studies have shown that mindfulness is associated with other smoking-related factors such as reduced withdrawal symptoms using cross-sectional data, relatively little is known about the associations between baseline mindful attention and future abstinence-related effect/withdrawal. The current study sought to examine whether levels of mindful attention before cessation predicts negative affect, withdrawal, and level of expired carbon monoxide (CO) on quit day, and also 3 and 7 days after quitting, during a self-quit attempt. METHODS: Data from 58 adults (mean ageâ=â34.9; 65.5% male) participating in a self-quit study were available for analysis. Self-report measures of mindful attention, negative affect, and withdrawal symptoms were collected. Biochemical measurement of expired CO was also collected. Dependent variables were assessed on quit day, and also 3 and 7 days after quitting. Covariates included age, race, sex, self-reported level of cigarette dependence, and smoking status through 7 days. Multivariate regression was used to evaluate the association of baseline mindful attention in relation to the studied outcomes. RESULTS: Greater mindful attention predicted lower negative affect and reduced withdrawal at all 3 time-points. Mindful attention did not predict levels of expired CO. CONCLUSIONS: The findings suggest that mindful attention before or during smoking-cessation treatment may help to reduce negative affect and withdrawal, which serve as barriers to cessation for many smokers.
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Afeto , Monóxido de Carbono/análise , Atenção Plena , Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Síndrome de Abstinência a Substâncias/prevenção & controle , Adolescente , Adulto , Idoso , Atenção , Testes Respiratórios , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Autorrelato , Estados Unidos , Adulto JovemRESUMO
Latinos are one of the fastest growing racial/ethnic population in the United States yet they experience a substantial amount of mental health disparities, such as anxiety and depression, compared with non-Hispanic Whites. The current study examined the interactive effects of rumination and mindful attention on anxiety and depression symptoms among economically disadvantaged Latinos. Participants consisted of 391 Latinos (86.7% female; Mage = 38.8 years [ SD = 11.4]; 95.3% first language Spanish) who attended a community-based primary health care clinic. Results provided support for an interaction effect of rumination with mindful attention in relation to depressive, suicidal, social anxiety, and anxious arousal symptoms as well as number of mood and anxiety disorders. The pattern of findings was consistent across each of these continuous dependent measures such that the highest levels of each affective variable were found for those with a combination of higher rumination and lower mindful attention. Unexpectedly, there was no interaction in relation to the dichotomous outcome of presence of any mood/anxiety diagnosis.
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Transtornos de Ansiedade/fisiopatologia , Ansiedade/fisiopatologia , Atenção/fisiologia , Depressão/fisiopatologia , Transtorno Depressivo/fisiopatologia , Atenção Plena , Ruminação Cognitiva/fisiologia , Suicídio , Adulto , Serviços de Saúde Comunitária , Feminino , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Atenção Primária à SaúdeRESUMO
The present investigation examined the moderating role of mindful attention in the relation between rumination and posttraumatic stress (PTS) symptoms (i.e., re-experiencing, avoidance, arousal, and total PTSD symptoms) among trauma-exposed Latinos in a primary care medical setting. It was hypothesized that mindful attention would moderate, or lessen, the relation between rumination and all facets of PTS, even after controlling for clinically relevant covariates. Participants included 182 trauma-exposed adult Latinos (89.0% female; Mage = 37.8, SD = 10.6% and 95.1% reported Spanish as their first language) attending a community-based integrated healthcare clinic in the Southwestern United States. Mindful attention was a significant moderator of relations between rumination and all PTS facets. Specifically, rumination and PTSD symptoms were significantly related yet only in the context of low (vs. high) levels of mindful attention. Mindfulness-based skills may offer incremental value to established treatment protocols for traumatic stress, especially when high levels of rumination are present. Rumination may also serve to identify those who are at greatest risk for developing PTSD after trauma exposure and, therefore, most likely to benefit from mindfulness-based strategies.
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Atenção , Hispânico ou Latino/psicologia , Atenção Plena , Atenção Primária à Saúde/estatística & dados numéricos , Ruminação Cognitiva , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Nível de Alerta , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol. METHODS: The sample included 197 daily cigarette smokers (MAge 34.81 years, SD = 13.43) who reported using cannabis and alcohol. RESULTS: Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms. CONCLUSIONS: The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.
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Adaptação Psicológica , Consumo de Bebidas Alcoólicas/psicologia , Depressão/psicologia , Fumar Maconha/psicologia , Motivação , Fobia Social/psicologia , Fumar/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Análise de Regressão , Índice de Gravidade de Doença , Fumar/terapia , Adulto JovemRESUMO
Cannabis use disorders (CUDs) co-occur with anxiety disorders at high rates, presumably because some individuals with anxiety disorders may rely on cannabis to manage anxiety. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, yet outcomes are worse for patients with elevated anxiety. The integration of MET-CBT with False Safety Behavior Elimination Treatment (FSET) may be useful with anxious CUD patients, as the use of cannabis to manage anxiety can be targeted as a false safety behavior. Here, we describe the integrated treatment and the successful use of it among two patients-one with CUD and comorbid social anxiety disorder (SAD) and one with CUD and comorbid SAD and generalized anxiety disorder. Data support the feasibility of this integrated treatment as a viable approach to the treatment of CUD and comorbid anxiety disorders. Future controlled trials are now warranted to further evaluate the intervention.
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OBJECTIVE: The present research examined the impact of cannabis motives on tobacco outcomes. METHODS: The sample included 403 daily smokers (214 males, mean age 35.24 years). A bifactor model of cannabis motives was examined to determine whether this approach might best elucidate relations between cannabis motives and smoking. RESULTS: Coping motives were associated with reduced barriers for smoking, fewer negative smoking expectancies, and decreased positive reinforcement with respect to smoking. Conformity motives were associated with fewer internal smoking barriers. Expansion motives were associated with more positive reinforcement related to smoking. Enhancement motives were associated with reductions in smoking for appetite/weight control consequences. The general motives variable, comprised of each of the five motives subscales, was associated with more barriers related to tobacco addiction, more external barriers, greater positive reinforcement consequences, and more negative expectancies. Coping motives were negatively associated with quit status, and were positively associated with quit status. CONCLUSIONS: Cannabis motives subscales were not uniformly predictive of quit success. Individuals who used cannabis for conformity reasons were more likely to successfully quit smoking, however, individuals who used cannabis for coping reasons were less likely to quit smoking. Thus, those who use cannabis for conformity reasons are less likely to turn to cannabis during times of stress or to relieve tension or anxiety, a view supported by existing literature. This suggests that individuals who use cannabis for coping reasons may represent a population vulnerable to cannabis misuse and problems. Additional work is needed to better understand underlying mechanisms.
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The present investigation examined the interactive effects of anxiety sensitivity and mindful attention in relation to anxiety and depressive symptoms and psychopathology among 145 adult Latinos (85.5% female; Mage=39.9, SD=10.8 and 98.6% used Spanish as their first language) who attended a community-based primary healthcare clinic. As expected, the interaction between anxiety sensitivity and mindful attention was significantly related to number of mood and anxiety disorders, social anxiety, and depressive symptoms. No significant interaction, however, was evident for panic (anxious arousal) symptoms. The form of the significant interaction indicated that Latinos reporting co-occurring higher levels of anxiety sensitivity and lower levels of mindful attention evinced the greatest levels of anxiety/depressive psychopathology, social anxiety, and depressive symptoms. These data provide novel empirical evidence suggesting that there is clinically-relevant interplay between anxiety sensitivity and mindful attention in regard to a relatively wide array of anxiety and depressive variables among Latinos in a primary care medical setting.