Alexithymia, Coping Styles and Traumatic Stress Symptoms in a Sample of Veterans Who Experienced Military Sexual Trauma.

The current study examined the association between alexithymia and coping styles (planning, positive reinterpretation and growth, social-emotion coping, and denial), and trauma symptoms in a clinical sample of 170 male and female veterans who experienced sexual trauma during military service. Denial was the only coping style positively associated with trauma symptoms, and it mediated the relationship between alexithymia and trauma symptoms. Alexithymia was negatively associated with planning. Likewise, alexithymia was negatively associated with social-emotional coping and with positive reinterpretation and growth. The results speak to the significant role that alexithymia has in predicting individual coping styles.

Alexithymia as a Mediator Between Childhood Maltreatment and Impulsivity.

Impulsivity, specifically negative urgency, is associated with diverse health risk behaviours, yet relatively little research has examined factors contributing to negative urgency. The purpose of this study was to examine the relationship between childhood maltreatment, alexithymia and negative urgency. The sample was comprised of 410 undergraduate students who completed measures online. A series of regression analyses tested whether alexithymia mediated the association between childhood maltreatment and negative urgency. Results supported the hypothesized mediation model. Subsequent analyses examined effects of specific subtypes of maltreatment and alexithymia subscales. These analyses indicated that growing up in a punishing environment (e.g. being hit or beat; expected to follow a strict code of behaviour) was indirectly associated with negative urgency via difficulty identifying feelings, suggesting that excessive use of punishment during childhood may reduce the development of the ability to identify and label feeling states. This difficulty in emotional processing may in turn lead to acting rashly when emotionally aroused.

Associations between sensitivity to punishment, sensitivity to reward, and gambling.

The majority of individuals gamble during their lifetime; however only a subset of these individuals develops problematic gambling. Gray's Reinforcement Sensitivity Theory may be relevant to understanding gambling problems. Differences in sensitivity to punishments and rewards can influence an individual's behavior and may be pertinent to the development of gambling problems. This study examined the functional associations between sensitivity to punishment (SP), sensitivity to reward (SR), and gambling problems in a sample of 2254 college students. Zero-inflated negative binomial regression was used to predict gambling problems as well as the absence of gambling problems. Gambling problems were hypothesized to be positively associated with SR and inversely associated with SP. In addition, SP was hypothesized to moderate the association between SR and gambling problems, attenuating the strength of the association. As hypothesized, SR was positively associated with gambling problems. However, SP did not moderate the relationship between SR and gambling problems. SP did, however, moderate the relationship between SR and the likelihood of never experiencing gambling problems. The results demonstrate that individual differences in SP and SR are functionally associated with gambling problems.

Child maltreatment and deliberate self-harm: a negative binomial hurdle model for explanatory constructs.

Emerging adults demonstrate the highest rates of deliberate self-harm (DSH) and thus represent a population in need of further study. While child maltreatment (CM) history is a risk factor for DSH, the mechanisms behind this relationship are not fully understood. This study tested a model of mechanisms linking CM with DSH (likelihood of engaging in the behavior and frequency among those who self-harm) via negative urgency (tendency to engage in impulsive behaviors under conditions of negative affect), distress tolerance, sense of control, and desire for control in a sample of college students. As hypothesized, CM had a strong positive direct association with both the likelihood and frequency of DSH. CM was positively associated with negative urgency and inversely associated with distress tolerance and sense of control. Negative urgency was positively associated with DSH likelihood and frequency. Distress tolerance was not directly associated with DSH but was indirectly associated with DSH likelihood and frequency via negative urgency. Sense of control was not associated with the likelihood of engaging in DSH; however, among those who endorsed a history of DSH, sense of control was positively associated with DSH frequency. Desire for control was not associated with either CM or DSH.

An experience sampling study of PTSD and alcohol-related problems.

Posttraumatic stress disorder (PTSD) represents a debilitating psychiatric condition that is affecting the lives of many returning veterans. PTSD and alcohol use and dependence are highly comorbid. The purpose of this study was to understand the functional mechanisms between PTSD and alcohol use and problems. Specifically, the role of negative urgency and emotional intelligence were investigated as vulnerability and resiliency factors, respectively. This study utilized experience sampling to test associations between PTSD symptoms and alcohol use and related problems in a sample of 90 OIF/OEF veterans. Participants completed 8 brief questionnaires daily for 2 weeks on palmtop computers. Elevations in PTSD symptoms during the day were associated with subsequent increases in alcohol use and associated problems that night. PTSD symptoms were associated with greater problems above and beyond the effect of drinking level at both the within- and between- person level. Emotional intelligence was associated with lower negative urgency, fewer PTSD symptoms, and less alcohol use and associated problems. The effects of emotional intelligence were primarily indirect via negative urgency and the effects of negative urgency on alcohol use and problems were indirect via its positive association with PTSD symptoms. Hypothesized cross-level effects of emotional intelligence and negative urgency were not supported. The findings suggest a functional association between PTSD symptoms and alcohol consumption. The association between PTSD symptoms and alcohol consumption is consistent with a self-medication model. However, the significant associations between PTSD symptoms and alcohol problems, after controlling for use level, suggest a broader role of dysregulation.

Emotion differentiation and alcohol-related problems: the mediating role of urgency.

Deficits in emotional and behavioral regulation figure prominently in etiological models of alcohol-related problems. This study tests a model linking poor differentiation of emotion to alcohol-related problems via urgency. The sample consisted of 102 undergraduates between the ages 18 and 24 who reported moderate to heavy alcohol consumption. As hypothesized, negative urgency mediated the relationship between negative emotion differentiation and alcohol-related problems. However, contrary to hypothesis, positive urgency was not associated with either positive emotion differentiation or alcohol-related problems and the indirect effect of positive emotion differentiation via positive urgency was not significant. Instead, positive emotion differentiation exhibited a significant direct effect on alcohol-related problems. This study provides an initial examination of connections between specificity in labeling emotions, behavioral disinhibition, and problematic alcohol use. These findings suggest that poor differentiation of negative emotion may foster impulsive behavior when negatively aroused. Whereas, impulsive behavior when positively aroused may reflect heightened sensitivity to positive reinforcement, which may not be related to reflective processes underlying emotion differentiation.

I don't know how I feel, therefore I act: alexithymia, urgency, and alcohol problems.

This study examined the relationships between alexithymia, impulsivity, and alcohol use and related problems. The sample consisted of 429 undergraduate students who reported drinking alcohol at least once in the past 3 months. Negative urgency mediated the relationship between alexithymia and alcohol-related problems, whereas positive urgency mediated the relationship between alexithymia and alcohol consumption. In addition, positive urgency moderated the relationship between alexithymia and alcohol-related problems, increasing the strength of this association. These results indicate distinct relationships between alexithymia and negative urgency and positive urgency in predicting alcohol consumption and related problems. The findings of this research contribute to the body of the literature on alexithymia, self-regulation, and etiology of alcohol misuse and related consequences. Furthermore, the findings of the current study provide support for the importance of emotion identification and expression skills training in substance abuse treatment.

Child maltreatment and deliberate self-harm among college students: testing mediation and moderation models for impulsivity.

This study examined the relationship between child maltreatment, impulsivity, and deliberate self-harm in a sample of college students. Four subtypes of impulsivity (urgency, premeditation, perseverance, and sensation seeking) were examined. Results show that participants who report child maltreatment histories also report higher levels of negative affect and higher levels of impulsivity, specifically negative urgency. In addition, those who report histories of child maltreatment are more likely to endorse deliberate self-harm behaviors as an adult. Of the 4 subtypes of impulsivity, urgency was most strongly related to deliberate self-harm. Urgency, but not the other subtypes of impulsivity, mediated the relationship between child maltreatment and self-harm. The current study contributes to the understanding of the mechanisms behind deliberate self-harm behavior by suggesting that individuals with histories of child maltreatment are more likely to engage in deliberate self-harm in an attempt to quickly reduce intense negative affect.

Trait-based affective processes in alcohol-involved "risk behaviors".

This study tested a theoretical model of alcohol use, markers of extreme intoxication, and risk behavior as a function of trait affect, distress tolerance, and affect-based behavior dysregulation. Positive affective pathways to risk behavior were primarily expected to be indirect via high levels of alcohol use, while negative affect paths were expected to be more directly associated with engagement in risk behavior. In addition, we expected trait affectivity and distress tolerance would primarily exhibit relationships with alcohol use and problems through behavioral dysregulation occurring during extreme affective states. To evaluate these hypotheses, we tested a SEM with three alcohol-related outcomes: "Typical" alcohol use, "blackout" drinking, and risk behavior. High trait negative affect and low tolerance for affective distress contribute to difficulty controlling behavior when negatively aroused and this is directly associated with increased risk behavior when drinking. In contrast, associations between positive urgency and risk behaviors are indirect via increased alcohol consumption. Positive affectivity exhibited both inverse and positive effects in the model, with the net effect on alcohol outcomes being insignificant. These findings contribute important information about the distinct pathways between affect, alcohol use, and alcohol-involved risk behavior among college students.

Difficulty identifying feelings predicts the persistence of trauma symptoms in a sample of veterans who experienced military sexual trauma.

The current study examined the prospective association between alexithymia and the persistence of trauma symptoms in a clinical sample of 175 male and female veterans who experienced sexual trauma during military service (military sexual trauma; MST). Trauma symptoms decreased significantly over the course of a specialized residential treatment program. Difficulty identifying feelings was related to persistence of the following trauma symptoms: overall symptoms, sexual abuse trauma symptoms, dissociative symptoms, and anxiety. Men exhibited more persistent symptoms overall, more persistent sexual problems, and more sexual abuse trauma symptoms compared with women (over and above controlling for symptoms at intake). The results speak to the significant role that difficulty identifying feelings has in the treatment of PTSD. In addition, the results suggest that MST has different implications for men compared with women. Specifically, men who were sexually abused in the military experienced greater persistence of symptoms compared with women, especially in the areas of sexual functioning.

Evaluations and expectancies of alcohol and marijuana problems among college students.

Two studies examined the associations between evaluations (good-bad) and expected likelihood (likely-unlikely) of alcohol- and marijuana-related problems and hazardous consumption and problems among college students. Participants provided data on alcohol use, alcohol-related problems, and expectancies and evaluations of alcohol problems; marijuana use indices, marijuana-related problems, marijuana effect expectancies, and likelihood and evaluations of marijuana problems. Evaluations of alcohol problems were positively related to the number of binge drinking occasions and alcohol-related problems. The interaction between evaluations and expectancies was significant in predicting the number of binge drinking occasions. Expectancies demonstrated a curvilinear relationship with binge drinking and alcohol-related problems. Marijuana users evaluated marijuana-related problems as less negative and less likely to occur than did nonusers. Expectancies, but not evaluations, of negative consequences were significantly associated with marijuana use intensity. Expectancies of problems demonstrated a curvilinear relationship with marijuana-use intensity and marijuana problems. Men evaluated alcohol and marijuana problems less negatively than did women. In summary, the expected likelihood of alcohol-marijuana problems and the evaluation of such problems represent a vulnerability factor associated with increased liability for hazardous alcohol and marijuana use.

Risk for marijuana-related problems among college students: an application of zero-inflated negative binomial regression.

METHOD: This study examined the association between marijuana-related problems and social norms, impulsivity, and perceived use utility among 292 college students. Zero-inflated negative binomial regression was used to simultaneously predict expected nonusers as well as predict counts of reported marijuana-related problems among expected users. Gender, social norms, impulsivity, and perceived use utility were used to predict expected nonusers as well as number of marijuana-related problems among expected users. RESULTS: Only social norms were associated with the prediction of zero-values. In contrast, only perceived use utility was associated with the prediction of number of marijuana-related problems. CONCLUSIONS: Results generally are consistent with theories of the differential association of social-environmental and biopsychological variables with use and problems, respectively. Zero-inflated regression models are a useful strategy to examine risk behaviors with low base rates.

Coping motives and trait negative affect: testing mediation and moderation models of alcohol problems among American Red Cross disaster workers who responded to the September 11,2001 terrorist attacks.

This study explored the mechanism by which trait negative affect and alcohol coping motives are associated with alcohol-related problems in a sample of American Red Cross workers who participated in the relief operation following the attacks in New York City, the Pentagon, and the Pennsylvania crash site on Sept. 11th 2001. The results supported the mediation but not moderation model of coping motives. The support for the mediation model was fairly strong, including small to moderate associations between negative affect and alcohol problems, moderate to strong associations between negative affect and coping motives, and evidence of coping motives mediating the negative affect to alcohol problems relationships. The association between negative affect and coping motives was stronger among younger participants.

An experience sampling study of associations between affect and alcohol use and problems among college students.

OBJECTIVE: This study used experienced sampling methodology to examine the relationship between affective functioning and alcohol consumption and problems. METHOD: Fifty-six college students provided baseline data on measures of impulsivity and distress tolerance and provided experience sampling data for 2 weeks on measures of negative affect, positive affect, and alcohol consumption and problems. Women made up 54% of the sample. The sample ranged in age from 21 to 23 (mean [SD] = 21.50 [0.57]); 98% were white and 2% were Asian. RESULTS: As predicted, higher levels of both positive and negative affect during the day were associated with higher rates of consumption that night. In contrast, negative, but not positive, affect was associated with alcohol-related problems after controlling for alcohol consumption. Impulsivity was associated with higher consumption and problems and moderated the relationships between negative affect and problems and also between alcohol consumption and problems. Low distress tolerance was associated with a decreased association between positive affectivity and alcohol consumption. CONCLUSIONS: This study replicated and extended previous research on affective models of alcohol use and problems through the use of experience sampling methodology. The results demonstrated associations between affective variables and alcohol consumption and problems measured through near real-time assessment. The results suggest a functional association between alcohol consumption and problems and both within-person changes in affect and between-person differences in impulsivity and distress tolerance.

An affective-motivational model of marijuana and alcohol problems among college students.

The study examined models of marijuana (n = 309) and alcohol (n = 731) problems. Impulsivity was directly associated with both marijuana- and alcohol-related problems. Negative mood regulation expectancies were indirectly associated with marijuana problems through coping motives. Sensation seeking was indirectly associated with alcohol problems through enhancement motives. Affect lability and negative affect were indirectly associated with alcohol problems though coping motives. In both models, coping motives were directly associated with use-related problems. A multigroup analysis indicated that the association between negative affect and coping motives as well as use and problems was stronger among participants using both alcohol and marijuana relative to alcohol only. Enhancement motives were a stronger predictor of alcohol use among participants using alcohol only.

Club drug use among college students.

This study examined prevalence and frequency of "club" drug use among college students (N=831) and associations with marijuana and alcohol use, sensation seeking, and positive and negative affectivity. Eighteen percent (n=146) of the sample had used club drugs at least once in their lifetime. Results of a logistic regression indicated that club drug use was positively associated with marijuana use, negative affectivity, and female gender. Among those who had tried club drugs in their lifetime, 42% reported no past year use and 22.6% reported using 7-12 times or more in the past year. Regression analysis examined associations between 12-month use frequency and the predictors among those who had tried club drugs. Results indicated that sensation seeking and marijuana use were positively associated with use frequency.

Methamphetamine and alcohol abuse and dependence symptoms: associations with affect lability and impulsivity in a rural treatment population.

The present study examined associations between impulsivity and affect lability and methamphetamine and alcohol abuse and dependence symptoms in a rural inpatient treatment population (N=235). Thirty-two percent of participants reported methamphetamine use in the past 90 days prior to admission. Amphetamine use disorders were found to be more common among younger participants whereas alcohol use disorders were more common among older and Native American participants. After controlling for age, gender, use frequency, and injection use, impulsivity but not affect lability was associated with methamphetamine abuse but not dependence symptoms. Lability but not impulsivity was associated with alcohol dependence but not abuse symptoms after controlling for age, gender, and use frequency. Consistent with past epidemiological studies, results indicate that methamphetamine use is a prominent problem facing rural substance use treatment facilities. Affect lability and impulsivity are associated with methamphetamine and alcohol-related problems in this population.

Associations between alcohol use and PTSD symptoms among American Red Cross disaster relief workers responding to the 9/11/2001 attacks.

OBJECTIVE: This study examined associations between alcohol use and PTSD symptoms among Red Cross workers who responded to the 9/11/2001 attacks. METHOD: Participants were 779 Red Cross paid and volunteer staff that responded during the first three months to the September 11, 2001, attacks against the United States. Women made up 64% of the sample. The American Red Cross provided a mailing list of all paid and volunteer staff (N = 6055 with valid addresses) that participated in the disaster relief operations in response to the September 11, 2001, attacks. Participants were randomly assigned to receive one of four questionnaire packets. The present study is based on the fourth group, which received the alcohol questionnaires. RESULTS: Overall, traumatic stress symptoms and alcohol use were low. Hyperarousal and intrusion symptoms on the Impact of Events Scale-Revised (IES-R) were associated with alcohol consumption, hazardous alcohol consumption, and change in alcohol consumption when controlling for age, gender, and worksite. Positive associations between Intrusion and Avoidance scores and hazardous consumption were stronger for younger participants. Individuals who reported increasing or decreasing alcohol use had higher IES-R scores than did those who maintained their normal rate of alcohol consumption, though effects were stronger for increasing alcohol use. Associations between alcohol variables and avoidance symptoms were minimal. CONCLUSIONS: The results suggest that there is a functional relation between posttraumatic stress symptoms and alcohol consumption. The study indicates that efforts to cope with traumatic stress symptoms may manifest in either increases or decreases in alcohol consumption.

Lability and impulsivity synergistically increase risk for alcohol-related problems.

This study examined two aspects of affect dysregulation as risk factors for alcohol-related problems. From a sample of 592 undergraduates, 442 alcohol users were examined on measures of impulsivity, lability, alcohol use, and alcohol-related problems. As expected, affect lability and impulsivity significantly increased risk for alcohol problems even after controlling for gender and lifetime-use frequency. Impulsivity was further examined as a vulnerability factor, potentially enhancing the relations between use frequency and problems and affect lability and problems. Impulsivity did not moderate the use frequency-problems relationship. However, the relationship between affect lability and problems was greatest among participants with higher degrees of impulsivity. The results demonstrate that individual differences in affect dysregulation are associated with alcohol-related problems in young adults.

Attitudes toward alcohol and drug-free experience among college students: relationships with alcohol consumption and problems.

This study examined prospective relations between attitudes toward alcohol use and drug-free experience and alcohol consumption and problems in 231 undergraduate students (73% women). Attitude toward drug-free experience was hypothesized to moderate the alcohol attitude--behavior relationship. Participants were assessed twice, separated by a 30-day interval. Attitude toward alcohol use at Time 1 was associated with alcohol consumption at Time 2. Time 1 attitude toward alcohol use and the interaction between the attitude variables were associated with problems at Time 2, indicating that attitude toward alcohol use was less associated with alcohol problems among participants with more positive attitudes toward drug-free experience. Attitude toward drug-free experience acted as a protective factor, reducing the relationship between alcohol attitude and alcohol-related problems.