Symptom change prior to treatment discontinuation (dropout) from a naturalistic Veterans Affairs evidence-based psychotherapy clinic for PTSD and depression.

Dropout or treatment discontinuation from evidence-based psychotherapies (EBPs) has been a concern for clinicians as it is thought that such discontinuation prevents patients from achieving a full course of therapy and obtaining maximum benefit. Recent studies, however, suggest that treatment discontinuation may sometimes be due to symptom improvement. The purpose of the current evaluation was to examine change in self-reported symptoms in participants who completed versus did not complete treatment in a Veterans Affairs outpatient clinic offering EBPs for both depression and posttraumatic stress disorder (PTSD). Data were collected from 128 participants who had at least one treatment session postintake and had been discharged from the clinic. Data were collected on self-reported PTSD and depression symptoms. Of the 128 veterans, 61 completed treatment and 67 did not complete treatment (54.0% noncompletion in PTSD EBPs and 48.7% noncompletion in depression EBPs). Of those who did not complete, 47 were enrolled in a PTSD EBP and 20 in a depression EBP. Of those who did not complete a PTSD EBP, 51.1% had no change in PTSD symptoms prior to treatment discontinuation, whereas 12.8% had a symptom increase, and 27.7% had a symptom decrease. Of those who did not complete a depression EBP, 55% had no change in depression symptoms prior to treatment discontinuation, 15% had a symptom increase, and 30% had a decrease. Overall, results suggest that treatment discontinuation is not as straightforward as it may seem and that prematurely discontinuing an EBP may not necessarily represent treatment failure. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How Harmonious and Obsessive Passion for Alcohol and Marijuana Relate to Consumption and Negative Consequences.

OBJECTIVE: Although the concepts of harmonious and obsessive passion have been productive in explaining why people eagerly engage in such activities as sports, Internet use, and gambling, previous research has not yet extended these models to explain alcohol and marijuana use among college students. The current research was conducted to clarify the relationships among harmonious and obsessive passion, alcohol and marijuana use, and negative consequences. METHOD: Two studies were conducted using online assessments. In Study 1, 748 heavy drinking college students (58% female) were recruited and completed measures of passion for drinking alcohol, alcohol use, and alcohol-related negative consequences. In Study 2, 352 regular marijuana-using students (54% female) were recruited and completed assessments of marijuana passion, marijuana use, and marijuana-related consequences. RESULTS: Study 1 found that among heavy drinking college students, harmonious passion was a stronger predictor of increased consumption than was obsessive passion, whereas obsessive passion was a stronger predictor of alcohol-related problems than was harmonious passion. Study 2 revealed similar findings with regard to harmonious passion predicting marijuana consumption; however, unlike Study 1, no significant difference between the passions was found in predicting marijuana-related problems. CONCLUSIONS: This research provides a novel perspective on motivation for alcohol and marijuana use. Findings suggest that understanding the locus of young adults' passion for substance use may be helpful in identifying those who are likely to develop a substance use disorder and therefore may be the most in need of assistance and intervention.

Coping motives as a mediator of the relationship between sexual coercion and problem drinking in college students.

Sexually coercive experiences, heavy alcohol use, and alcohol-related problems occur at relatively high base rates in college populations. As suggested by the self-medication hypothesis, alcohol consumption may be a means by which one can reduce negative affect or stress related to experiences of sexual coercion. However, few studies have directly tested the hypothesis that coping motives for drinking mediate the relation between sexual assault and problem drinking behaviors, and no published studies have tested this in men. The current study tested this hypothesis using structural equation modeling in a sample of 780 male and female undergraduates. Results revealed that coping motives partially mediated the relation between sexual coercion and drinking and alcohol-related negative consequences. In addition, direct and indirect paths between sexual coercion and drinking were found for men whereas only indirect paths were found for women. Results provide support for self-medication models of drinking and suggest the importance of exploring gender differences in mechanisms for drinking.

Alcohol consumption and intimate partner violence perpetration among college students: the role of self-determination.

OBJECTIVE: The present research examined the role of self-determination theory in alcohol consumption and intimate partner violence (IPV) perpetration among college students. We were interested in evaluating the extent to which individual differences in self-determination (i.e., autonomous and controlled orientations) may influence problematic alcohol use and male-to-female IPV perpetration and the extent to which problem drinking may mediate the associations between self-determination and IPV perpetration. METHOD: A total of 313 incoming heterosexual, male freshman drinkers at a large northwestern university between the ages of 18 and 21 years completed self-report measures of autonomous and controlled orientations, alcohol use, and IPV perpetration as part of a larger social norms intervention study. Analyses evaluated the influence of autonomous and controlled orientations on alcohol consumption, associated problems, and IPV perpetration. RESULTS: The proposed model fit the data relatively well, chi(2) (11, N = 313) = 32.19, p = NS, root mean square error of approximation = .079, normed fit index = .95, nonnormed fit index = .93, comparative fit index = .96. Both autonomous and controlled orientations had significant direct and indirect effects on perpetration through alcohol consumption. Although the model fit the data well, it explained a relatively small amount of variance in both alcohol consumption (5%) and perpetration (7%). CONCLUSIONS: Findings support previous research implicating the role of alcohol in IPV perpetration. Additionally, our findings suggest that self-determination theory may be a useful heuristic in the examination of individual characteristics that promote alcohol consumption and IPV perpetration.

Fitting in and feeling fine: conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students.

Intimate partner violence perpetration and problem drinking among college students: The roles of expectancies and subjective evaluations of alcohol aggression.

OBJECTIVE: The present research examined the effect of alcohol aggression expectancies and subjective evaluations of alcohol's effects on aggression in intimate partner violence (IPV) perpetration among college students. We were interested in determining the extent to which these relationships differed across gender. METHOD: A total of 780 (57.3% female) incoming heavy drinking college freshmen who were between the ages of 18 and 25 years completed self-reported measures of IPV perpetration, alcohol use and problems, and alcohol aggression expectancies and subjective evaluations of those expectancies as part of the baseline assessment for a larger social norms alcohol intervention study. Analyses evaluated the effect of alcohol aggression expectancies and subjective evaluations of those expectancies on IPV perpetration. RESULTS: Results indicated that problem drinking was positively associated with IPV perpetration for those who were lower (beta = .32, p < .001) versus those who were higher (beta = .07, p = ns) in alcohol aggression expectancies. Among men, there was a significantly stronger relationship between problem drinking and IPV perpetration among those who evaluated alcohol's effects on aggression more favorably (beta = .41, p < .001) versus less favorably (beta = .11, p = ns). Among women, there was not a significantly stronger relationship between problem drinking and IPV perpetration at less favorable (beta = .17, p < .05) versus more favorable (beta = .11, p < .06) evaluations of alcohol's effects on aggression. CONCLUSIONS: Findings suggest that, in understanding IPV perpetration, it may not be sufficient to evaluate expected alcohol effects without also including whether those effects are viewed as good or bad. Findings also suggest that the relationship between alcohol problems and IPV perpetration may be stronger and more straightforward for men than for women.