Alexithymia, Prior Trauma, Alcohol Use, and Sexual Aggression Perpetration: A Cross-Cultural Comparison of a Moderated Mediation Model.

In this study, we examined the relationships between prior trauma, alexithymia, and sexual aggression perpetration among 610 U.S. college students and 107 college students from the Philippines utilizing a cross-sectional retrospective design. We tested a moderated mediation model with alexithymia as the mediator between prior trauma and sexual aggression perpetration, and alcohol use as a moderator of the alexithymia-sexual aggression link. Moreover, given that cultural norms may influence these relationships, we also examined the structural invariance of the proposed moderated mediation model. Path analyses and multiple group analysis were used to examine the moderated mediation model, and examine model differences between samples. We did not find evidence for alexithymia as a mediator, but there was a significant interaction between alcohol use severity and alexithymia on sexual aggression perpetration across both samples. Alexithymia is a key variable in understanding the alcohol use-sexual aggression perpetration relationship. Clinical implications and recommendations for future research are also discussed.

The Desire to Dissociate Scale: factor analysis, cross-cultural findings, and links to substance-induced dissociation.

BACKGROUND: Past research identified that a desire for dissociative experiences, rather than dissociative tendencies, mediate the relationship between early sexual abuse and problem drinking in college students. Desire to dissociate was conceptualized as a mechanism facilitating substance-induced dissociation or the use of substances to achieve dissociative-like experiences and was measured using a modified version of the Dissociative Experiences Scale-II. The validity and cross-cultural generalizability of the modified scale are not yet known. OBJECTIVES: The current study examined the psychometric properties of the modified scale, exploring findings across U.S. and Filipino college samples, and explored how the desire to dissociate construct related to other variables linked to substance-induced dissociation. Methods: Participants were recruited across two U.S. samples and one Filipino sample (N = 2404; 72% female). Instead of asking "how often do you experience" dissociative items, 14-items from the original scale were selected and individuals were asked "how often would you like to experience" items. RESULTS: Results supported the validity of the Desire to Dissociate Scale (DDS) with a bifactor model best fitting the data in U.S. and Filipino samples. The bifactor model identified that the DDS primarily measured a general 'desire to dissociate' factor and two specific factors comprised smaller portions of the variance. DDS scores were positively correlated with trauma-related and alcohol use variables including drinking to cope, variables conceptually consistent with theories of substance-induced dissociation. CONCLUSION: Clinical implications address avoidant coping patterns and differences in specific factor findings between U.S. and Filipino samples.

A comparison between telehealth and face-to-face delivery of a brief alcohol intervention for college students.

BACKGROUND: Problematic alcohol use is a common occurrence among college students. While empirically supported interventions exist, their access is typically limited to those with greater resources. There has been an expansion of services provided via telehealth to increase client access to treatment in the health care field. However, the evidence is mixed regarding the effectiveness of face-to-face versus telehealth interventions and there is a gap in the literature regarding brief alcohol interventions delivered via telehealth. As such, the purpose of this study was to test the effectiveness of a well-validated brief alcohol screening and intervention for college students (BASICS) when conducted face-to-face or through a videoconferencing system. Method: Participants included 51 college students who engaged in heavy episodic drinking (5+ drinks for males and 4+ drinks for females over a two hour period) over the last two weeks. They were randomly assigned to receive the face-to-face or telehealth intervention and completed a variety of questionnaires throughout. Follow up data on the participant's alcohol use and alcohol-related problems was collected at 1-, 2-, and 3-months. Multilevel modeling in SAS was utilized for analyses, which included the modeling of treatment outcome trajectories and the influence of predictors on the trajectory of change for each outcome. Results: Results indicated that the intervention significantly reduced alcohol consumption and related problems regardless of condition. Both conditions saw an increase in treatment satisfaction and therapeutic alliance between the two sessions. Increased therapeutic alliance resulted in greater decreases in alcohol use and related harm across both conditions. Additionally, those with a mental health diagnosis showed greater improvement related to risk reduction for both treatment modalities. Conclusion: In sum, the results of this study suggest that telehealth services should be further implemented and the BASICS intervention can be effectively delivered via telehealth for college students.

Measuring individual differences in responses to date-rape vignettes using latent variable models.

Vignette methodology can be a flexible and powerful way to examine individual differences in response to dangerous real-life scenarios. However, most studies underutilize the usefulness of such methodology by analyzing only one outcome, which limits the ability to track event-related changes (e.g., vacillation in risk perception). The current study was designed to illustrate the dynamic influence of risk perception on exit point from a date-rape vignette. Our primary goal was to provide an illustrative example of how to use latent variable models for vignette methodology, including latent growth curve modeling with piecewise slopes, as well as latent variable measurement models. Through the combination of a step-by-step exposition in this text and corresponding model syntax available electronically, we detail an alternative statistical "blueprint" to enhance future violence research efforts using vignette methodology. Aggr. Behav. 43:60-73, 2017. © 2016 Wiley Periodicals, Inc.

Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma.

OBJECTIVE: Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom-alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies. METHODS: Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems. RESULTS: Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures. CONCLUSIONS: This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

Factor structure and invariance test of the alcohol use disorder identification test (AUDIT): Comparison and further validation in a U.S. and Philippines college student sample.

The Alcohol Use Disorder Identification Test's factor structure varies depending on population and culture. Because of this inconsistency, this article examined the factor structure of the test and conducted a factorial invariance test between a U.S. and a Philippines college sample. Confirmatory factor analyses indicated that a three-factor solution outperforms the one- and two-factor solution in both samples. Factorial invariance analyses further supports the confirmatory findings by showing that factor loadings were generally invariant across groups; however, item intercepts show non-invariance. Country differences between factors show that Filipino consumption factor mean scores were significantly lower than their U.S. counterparts.

Posttraumatic stress disorder symptoms, emotion dysregulation, and aggressive behavior among incarcerated methamphetamine users.

OBJECTIVE: Methamphetamine use remains a prevalent problem in the United States and is linked to numerous deleterious outcomes, including aggressive behavior, criminal activity, and incarceration. Given these associations, a greater understanding of factors that contribute to aggression among users of methamphetamine is needed, particularly within criminal justice settings, where users of this drug are overrepresented. METHODS: The present study examined the relationships between posttraumatic stress disorder (PTSD) symptoms and emotion dysregulation and in-prison physical aggression among incarcerated males who identified as methamphetamine users (N = 60). RESULTS: Participants' average age was 34.4 years (SD = 7.9), and they were predominantly European American (n = 48, 80%), had spent an average of 6.53 years incarcerated (SD = 4.64), and perpetrated about 1.54 acts of aggression (SD = 6.74) during the past three months. Bivariate correlations found that greater PTSD symptoms (p < .001), greater impulse control difficulties (p < .001), and limited access to emotion regulation strategies (p < .05) were associated with aggression perpetrated in prison. However, results from multiple regression analyses indicated that only PTSD symptoms (p <.001) and nonacceptance of emotional responses (p < .03) were predictive of aggression. Regression analyses also suggested that impulse control difficulties (p < .001), limited access to emotion regulation strategies (p < .04), and nonacceptance of emotional responses (p < .001) interacted with PTSD symptoms to predict increased aggressive behavior. The first interaction ran counter to study hypotheses: At greater levels of PTSD symptoms, those with greater acceptance of emotional responses reported greater aggression perpetration than those with lesser acceptance of emotional responses. The other two interactions were in line with hypotheses, showing that at greater levels of PTSD symptoms, those with greater impulse control difficulties (or lesser access to emotion regulation strategies) reported more aggressive behaviors. CONCLUSIONS: Consistent with theories of aggression, study findings suggest that PTSD symptoms bolster the risk of aggression via various forms emotion dysregulation. Results shed light on potential mechanisms that promote in-prison aggression and violent recidivism among this population.

Biopsychosocial pathways to alcohol-related problems.

BACKGROUND: Drinking to cope has been associated with negative consequences among college students. Less is known about the biopsychosocial pathways that increase the susceptibility to these drinking problems. This study aims to assess the relationship between biopsychosocial variables that have been shown to impact substance-based coping (ie, alexithymia, childhood/adolescent abuse, and genetics). METHODS: Self-report and genetic [DRD2 genotype (A1- or A1+)] information were collected from 297 participants. RESULTS: Using structural equation models, results found that greater amounts of emotional abuse predicted alexithymia, and substance-based coping predicted drinking problems among both groups. However, among persons with the A1+ allele, greater levels of alexithymia were associated with greater levels of substance-based coping. CONCLUSIONS: These results indicate that the A1+ allele may link alexithymia and prior emotional abuse to a higher risk for substance-based coping and subsequent alcohol problems.

A Restorative Justice Intervention in United States Prisons: Implications of Intervention Timing, Age, and Gender on Recidivism.

Restorative justice seeks to balance the needs of the victim, offender, and community by repairing the harm caused by crime and wrongdoing and improving the prosocial competencies and accountability of the offender in response to an offense. Restorative justice interventions (RJIs) offer an alternative method to reduce harm and short- and long-term recidivism. However, empirical validation of mechanisms and moderating factors warrant additional inquiry within jail and prison settings. Thus, the authors sought to examine RJI delivery timing on recidivism outcomes with age and gender as moderators. A final sample of 1,316 individuals (49.8% female) incarcerated in several United States prisons received an RJI between 2001 and 2017. RJI timing did not relate to binary recidivism. However, women recidivated less than men and older individual recidivated less than younger individuals. For the subsample of reoffenders (n = 283), RJIs delivered closer to release increased the amount of time before recidivism. Delivering RJIs closer to release from prison may allow for other community programs to intervene and reduce recidivism even further.

Trait mindfulness weakens the relationship between Snapchat use and alcohol-related outcomes.

Objective:Previous studies identified Snapchat as the most likely social media platform for depictions of excessive drinking and consequences. We sought to further examine this relationship and the possible protective impact of trait mindfulness.Method:A sample of 838 college students completed a survey assessing self-reported alcohol use, alcohol-related consequences, trait mindfulness, and individual and peer alcohol-related Snapchat posts.Results:Viewing more peer's Snapchats was associated with increased alcohol-related consequences, except at high levels of trait mindfulness. When controlling for the individual's Snapchat posts, the significant relationship between peer's Snapchats and consequences remained at low levels of trait mindfulness but not for moderate levels. The protective effect of high levels of trait mindfulness endured.Conclusion:Increasing trait mindfulness may help buffer the negative influence of viewing peer's alcohol-related Snapchats on alcohol-related consequences. Further examining how trait mindfulness interacts with peer norms offers important avenues for future research.

Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy.

BACKGROUND: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. METHODS: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. RESULTS: Total adherence rates to the BT plan were 51-52% at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). CONCLUSIONS: Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.

Prenatal exposure to testosterone interacts with lifetime physical abuse to predict anger rumination and cognitive flexibility among incarcerated methamphetamine users.

The present pilot study hypothesized that degree of exposure to prenatal testosterone interacts with a history of lifetime physical abuse (LPA) to predict the cognitive (anger rumination) and behavioral (intimate partner and interpersonal violence) components of aggression within incarcerated methamphetamine (MA) users. In addition, we hypothesized that the degree of exposure to prenatal testosterone interacts with LPA to predict cognitive flexibility (Stroop Color-Word performance). Male inmate MA users (N = 60) completed neuropsychological and paper/pencil tests. Hand photocopies were also obtained to index prenatal testosterone exposure. Five covariate-adjusted moderation models were tested using anger rumination, intimate partner violence (IPV) perpetration, interpersonal violence perpetration (before and while incarcerated), and Stroop Color-Word T-score as the criteria, prenatal testosterone exposure as the predictor, and LPA as the moderator. Results indicated that, in individuals with a history of LPA, exposure to higher levels of prenatal testosterone exposure predicted greater anger rumination, lower Stroop Color-Word test T-scores, and lower frequencies of IPV perpetration. Findings were not significant in individuals without a history of LPA. This research suggests that biochemical and psychosocial vulnerabilities influence anger rumination and cognitive flexibility, which may render incarcerated MA users at greater risk to relapse or recidivate upon release from prison.

Desire to dissociate: implications for problematic drinking in college students with childhood or adolescent sexual abuse exposure.

Alcohol use to replace inadequate dissociative capabilities, or chemical dissociation, has been linked to college students with childhood or adolescent sexual abuse (CASA). Insofar as CASA-exposed persons experience a restricted range of dissociative capabilities, what remains relatively unclear is whether some desire to achieve greater dissociative experiences. Nonclinical levels of dissociative tendencies have positively predicted alcohol-related blackouts in CASA-exposed students, and dissociation mediated the relations between CASA and intoxication frequency. Although alcohol (similar to dissociation) can reduce physiological and psychological responses to stress, alcohol consumption may be prompted by a desire to dissociate rather than inadequate dissociative tendencies alone. To investigate this interpretation of the chemical dissociation phenomenon, researchers examined the mediating potential of dissociative tendencies using the Dissociative Experiences Scale-II (DES-II) as well as the desire to dissociate concept (ie, a modified version of the DES-II) on the relations between CASA exposure and problematic alcohol use in college students (N = 298). Results indicated that dissociation scores did not replicate previous mediation findings whereas desire to dissociate scores fully mediated CASA exposure and problematic alcohol use. Implications of the results are discussed including possible reasons why prior mediation results were not replicated as well as links to experiential avoidance.

Mood and cue reactivity among smokers with a history of major depression: the role of rumination and impulsivity.

The present study tested the influence of rumination and impulsivity on experimentally induced negative mood among a sample of smokers with a lifetime history of major depression (MDD Hx+). Participants (N = 40) were categorized into four vulnerability groups: nonvulnerable (low rumination, low impulsivity), ruminative (elevated rumination, low impulsivity), impulsive (low rumination, elevated impulsivity), and vulnerable (elevated rumination, elevated impulsivity). Participants were counterbalanced to four experimental conditions, using a combination of a mood induction (negative mood induction vs. control) and smoking cue (in vivo cigarette vs. control cue). Although all participants reported greater anger responses when exposed to the negative mood induction versus control, vulnerable and ruminative smokers reported significantly greater anger responses than impulsive and nonvulnerable smokers [F(9,87) = 2.93, p = .038, Mse = 79.38]. Implications are discussed.

A Cross-Cultural Comparison of the Role of Sexual Objectification in the Relationship Between Alcohol Use and Sexual Assault Perpetration.

In this study, we examined how sexual objectification can help explicate the relationship between alcohol use and sexual assault perpetration. Specifically, we examined a mediation and a moderation model. Moreover, given that gender roles and sexual norms vary across cultures, we also examined the structural invariance of the models between a U.S. male (n = 404) and Philippines male (n = 100) college sample. Path analyses were used to examine the mediation and the moderation model, and multiple groups analysis was utilized to examine model differences between samples. Sexual objectification fully mediated the relationship between alcohol use severity and sexual aggression. Furthermore, the mediation model was invariant between the U.S. sample and Philippines sample. A significant alcohol use severity by sexual objectification interaction effect was found for both samples. Simple slopes analysis indicated that alcohol use severity was not associated with sexual aggression among those with high sexual objectification scores. Among men with low sexual objectification scores, alcohol use severity was associated with higher likelihood toward sexual assault. For the Filipino sample, the impact of alcohol consumption on sexual aggression is more pronounced compared with the U.S. sample. Sexual objectification is a key variable in understanding the alcohol use-sexual aggression relationship. Country differences in alcohol use, cultural meanings of Filipino masculinity, and sexual norms and behaviors accounts for noninvariance in the moderation model. Implications for sexual assault reduction programs were also discussed.

Toronto Alexithymia Scale-20: Examining 18 Competing Factor Structure Solutions in a U.S. Sample and a Philippines Sample.

The Toronto Alexithymia Scale-20 is arguably the most utilized measure of alexithymia. Although a three-factor solution has been found by numerous studies, these findings are not universal. This article examined and compared 18 competing factor structures for the Toronto Alexithymia Scale-20, which included between one and four correlated latent factor structures, common methods models that accounts for negatively worded items, and bifactor models. Although the two-factor bifactor model with a common methods factor had the better model fit compared with the other 17 models examined, it still did not achieve the requisites of a good model fit across all model fit indices. Issues stemmed primarily from the externally oriented thinking factor and the negatively worded items. Post hoc analyses indicated that a two-factor bifactor model with the negatively worded items dropped achieved the requisites of a good model fit and can be treated as a unidimensional measure despite the presence of multidimensionality. Multiple-group analysis indicated that the factor loadings were invariant across U.S. and Philippines samples. After controlling for noninvariance at the item intercept level, the Philippines sample had a higher alexithymia general score compared with the U.S. sample.

Coerced childhood sexual abuse moderates the association between cigarette smoking initiation and college drug use frequency.

The current study examined childhood sexual abuse (CSA) as a potential moderator of the "gateway theory" association of cigarette use onset and college drug use. Covariate adjusted hierarchical regressions showed that CSA history interacted with age of first cigarette to predict total 12-month illicit drug use frequency (Delta R(2) =.048, F(10, 76) = 4.041, Mse = 8.812, p =.021). Simple effects revealed that age of first cigarette predicted drug use frequency in individuals with CSA histories (p =.045) rather than non-CSA individuals (p =.103). Exploratory analyses further revealed that the CSA moderation was carried primarily by those exposed to forced/coerced CSA events. Implications of the findings are discussed.

Cue-evoked positive affect, depression vulnerability and smoking years.

OBJECTIVES: To evaluate whether cue-evoked affective response would moderate the relationship between depression-proneness and smoking years. METHODS: Depression-proneness profiles were derived using clinician diagnosed personal and family histories of major depression, recurrent depression, trait-anhedonia, and ruminative coping styles (n=70). Affective distress was produced by idiographic, guided negative mood imageries in the presence of an in vivo cigarette exposure. RESULTS: Contrary to expectations, results showed that individuals less vulnerable to depression reported longer smoking histories. Stress-induced decreases in positive affect bolstered the association between depression vulnerability and smoking years. CONCLUSION: Depression-proneness assumptions are challenged and implications to affective influences on smoking behavior are discussed.

Long-Term Effectiveness of a Brief Restorative Justice Intervention.

This research investigated the effectiveness of a brief Restorative Justice Intervention. Probationers who attended a Restorative Justice Intervention ( n = 383) were compared with probationers receiving treatment as usual ( n = 130) over a 2- to 6-year follow-up period. The proportion of individuals who recidivated in the control condition ( n = 89, 68.46%) were higher compared with those who recidivated in the intervention condition ( n = 127, 33.16%; z = 7.04, p < .001). In addition, among those who recidivated, those in the intervention condition did so less frequently. Qualitative analyses from a postintervention course evaluation given only to the intervention condition showed that 50% of probationers acknowledged an empathic understanding associated with participation. This brief intervention has a positive multilevel impact on restorative justice. Implications of these effects are discussed.

Child sexual abuse, dissociation, and alcohol: implications of chemical dissociation via blackouts among college women.

The present study examined whether childhood sexual trauma moderated the relationships between dissociation and both problematic college drinking and alcohol-induced blackouts among a sample of college females (N = 156). Cross-sectional data were consistent with the moderation hypotheses. Simple effects showed that the relationship between dissociation and blackout frequency as well as problematic drinking only existed among those with sexual trauma histories (p < .035), but not among those reporting no sexual trauma exposure (p = .333). Findings implicate the use of alcohol as a possible maladaptive coping mechanism among college females with childhood sexual trauma.