Neurocognitive Latent Factors Associate With Early Tobacco and Alcohol Use Among Adolescent Brain Cognitive Development Study Youth.

PURPOSE: Prospective associations between preadolescent neurocognitive structure and onset of substance use in adolescence have not been examined. This study investigated associations between cognitive structure among youth aged 9 - 10 years and the likelihood of experimentation with tobacco and alcohol by ages 13-14 years. METHODS: A principal component (PC) analysis of nine neurocognitive assessments was used to identify the cognitive structure of unrelated adolescent brain cognitive development study participants (n = 9,655). We modeled associations between neurocognitive PCs and odds of tobacco or alcohol use by ages 13-14 years using generalized linear mixed models with a logit link and random intercept for recruitment sites. Demographics, family conflict, neighborhood safety, and externalizing and internalizing behavior were considered covariates. RESULTS: Four neurocognitive PCs were identified and labeled general ability, executive function, learning and memory, and mental rotation. Mental rotation [odds ratio [OR] = 0.88, p-value = .013] was associated with lower odds of youth tobacco use; the association was stronger among female youth. General ability [OR = 1.20, p-value < .0001] among both males and females, and learning and memory [OR = 1.11, p-value = .024] among females, were associated with increased odds of youth alcohol use. DISCUSSION: Among youth, higher neurocognitive performance was protective for tobacco use but increased the likelihood of alcohol use. Potential sex differences were identified. The role of cognition in processing the social contexts surrounding tobacco and alcohol use in the United States may contribute to the formation of disparate youth expectancies for tobacco and alcohol use.

Predicting alcohol use with subjective and objective measures of cognitive function in healthy college students.

Objective: The current study examined the association between subjective and objective cognitive measures and alcohol use in college students. Objective cognitive impairment is associated with alcohol use, however subjective cognitive impairment remains understudied in at-risk populations. Participants: Data were collected from 140 undergraduate students at a mid-sized private university. Methods: We used the Behavior Rating Inventory for Executive Function-Adult (BRIEF-A) and the Rey-Osterrieth Complex Figure Task (ROCF) as our subjective and objective measures of cognitive functioning respectively. Results: In our regression model, the BRIEF-A was significantly associated with the AUDIT in college students such that more poorly perceived cognitive functioning predicted higher degrees of problematic drinking. However, the relationship between the ROCF and drinking was less clear. Conclusions: Our study shows that perception of one's cognitive functioning is related to alcohol use and may be a potential risk factor for hazardous drinking in college students. Our results also suggest that subjective functioning is more strongly related to alcohol use than objective functioning, however further research is needed to replicate our results.

Social isolation induces hyperactivity and exploration in aged female mice.

Prolonged social isolation is associated with poor physical and mental health outcomes, findings observed in both humans, and rodent models of isolation. Humans, like mice, may engage in enhanced exploratory and social behaviour following isolation, which may protect against subsequent cognitive decline and psychological distress. Understanding how these effects may impact behaviour in older adults is particularly relevant, as this population is likely to experience periods of late-life social isolation. We report that late-life social isolation in female mice did not lead to robust depressive-like symptomology, altered social interaction behaviour, sensitivity to context fear acquisition and memory, or alterations in inflammatory cytokines (IL-6, IL-1ß, Tnf-α) or microglial activation (Itgam) within the hippocampus. Rather, isolation increased hyperactivity and exploration behaviours. These findings have translational value as the first female mouse model of late-life social isolation, and provide evidence to inform the development of interventions aimed at promoting functional recovery following isolation in late-life.

Investigating Mental Health Implications for Drug Court Participants.

Drug Court Treatment (DCT) Programs seek to integrate substance abuse treatment into the criminal justice system by providing a structured environment for offenders who engage in treatment in lieu of incarceration. DCT has shown successes in reducing drug/alcohol use, recidivism, and cost, but the impact of DCT on non-substance-related mental health outcomes is less clear. This study evaluated mental health correlates within a DCT sample through analyses of participants' pre-entry and pre-graduation Minnesota Multiphasic Personality Inventory-Second Edition (MMPI-2) profiles. When diagnostic information was available, mood disorders had the highest comorbidity with alcohol/substance use diagnoses. Comparisons across administrations of the MMPI-2 indicated significant differences among mean scores on 6 Clinical scales, and mean profile elevation scores significantly decreased. Results suggest a significant presence of mental health comorbidities in DCT programs, and significant mental health improvements were seen for graduates, suggesting the utility of DCT for treating mental health problems in addition to substance use.

An epidemiologic study of suicide among firefighters: Findings from the National Violent Death Reporting System, 2003 - 2017.

Suicide is a significant concern among fire service due to high rates of suicide behaviors. The aim of this study was to describe suicides among firefighters using national suicide death data. Data from the National Violent Death Reporting System for 722 firefighters and 192,430 non-firefighters were analyzed to compare sociodemographics and risk factors between firefighter and non-firefighter decedents; and among firefighters based on suicide means. A greater proportion of firefighter decedents died by firearm compared to non-firefighters. Firefighter decedents were less likely to have been diagnosed with depression, but more likely to have been diagnosed with post-traumatic stress disorder compared to non-firefighters. A greater percentage of firefighter decedents had a relationship or physical health problem prior to death, but a lower percentage had a history of suicide thoughts/attempts. Among firefighter decedents, multivariate analysis showed physical health problems and disclosing suicide intent predicted death by firearm. Greater awareness of risk factors, reduced access to lethal means, and ensuring access to behavioral health services may aide in decreasing suicide mortality in this population. These findings should be interpreted with caution due to limitations concerning report accuracy, generalizability, small female sample size, and inclusion of data only for lethal suicide attempts.

The closed response style and posttraumatic stress: Examining the interaction between experiential avoidance and cognitive fusion among women experiencing sexual trauma.

OBJECTIVE: Experiential avoidance and cognitive fusion synergistically form what is known as the closed response style. Prior study findings indicate that the closed response style, examined as an interaction between experiential avoidance and cognitive fusion, relates to posttraumatic stress symptom severity among a heterogeneous sample of trauma survivors. The present study sought to extend those findings by examining the association between the closed response style and posttraumatic stress symptom severity specifically among women who survived a Criterion A sexual trauma. METHOD: The sample was 136 women attending a southern U.S. university who reported Criterion A sexual trauma exposure. Participants completed self-report measures assessing the study variables. RESULTS: The predicted interaction between experiential avoidance and cognitive fusion accounted for unique variance in posttraumatic stress symptom severity (total symptom severity, along with hyperarousal and alterations in cognitions and mood). Simple effects indicated that experiential avoidance and cognitive fusion only shared associations with posttraumatic stress symptom severity when coupled with high levels of the other process (i.e., cognitive fusion or experiential avoidance, respectively). CONCLUSIONS: Results provide further support for the potential relevance of the closed response style to posttraumatic stress. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Executive attention moderates the effect of trait anxiety on hyperarousal symptoms.

The majority of individuals exposed to trauma do not go on to develop posttraumatic stress disorder (PTSD); thus, researchers have sought to identify individual difference variables that make one particularly susceptible to posttraumatic stress symptoms. Trait anxiety is one individual difference variable implicated in the pathogenesis of posttraumatic stress symptoms. Following from cognitive theories of anxiety and extant data, the purpose of the present study was to examine executive attention as a moderator of the relation between trait anxiety and posttraumatic stress symptoms, particularly hyperarousal symptoms, among undergraduate women reporting trauma exposure (N = 88). As predicted, executive attention moderated the association between trait anxiety and hyperarousal symptoms, such that there was a significantly weaker relation as executive attention increased. Study results further support the potential buffering effect of executive attention in relation to posttraumatic stress symptoms, as well as the possible importance of targeting executive attention following trauma exposure.

Using the PAI-A to Classify Juvenile Offenders by Adjudicated Offenses.

To improve understanding and treatment of criminal behavior, researchers have developed typologies of juvenile offenders, primarily focusing on personality traits and criminal history to classify according to type of offense committed. Existing literature has examined underlying personality characteristics found in different subcategories of criminal offenses in juveniles; however, few studies have employed the Personality Assessment Inventory-Adolescent (PAI-A), instead choosing the MMPI-A. A typical classification model of juvenile offenses categorizes offenses into: Interpersonal, Property, and Drug/Alcohol-related charges, to further study within-group differences. The current study examines how personality profiles, examined by the PAI-A, can classify offenders into these offense-type groups. Personality profiles of participants were obtained through pre-sentencing psychological evaluations of 142 juvenile offenders ages 14 to 17. Binary logistic regressions were conducted using PAI-A Clinical, Treatment Consideration, and Interpersonal scales to predict offense-type group classifications. Results yielded statistically significant full models for all offense-type groups, with an average overall accuracy rate of 76.3%. Overall, results suggest that the PAI-A has good predictive power to classify juvenile offender types, and may be more effective in classifying certain types of offenders than the MMPI-A. Notably, Interpersonal and Treatment consideration scales were stronger predictors of offense-type than Clinical scales. This model of juvenile offender classification holds promise for more effective treatment, management, and prediction of behavior for juvenile offenders.

Metacognitive Beliefs Predict Greater Mental Contamination Severity After an Evoking Source.

Mental contamination occurs when individuals experience feelings of internal dirtiness and distress in the absence of physical contact with a contaminant. Women who experience sexual trauma frequently report mental contamination. The self-regulatory executive function (S-REF) model proposes that metacognitive beliefs contribute to the appraisal and regulation of thinking, leading to expectations that metacognitive beliefs would predict greater mental contamination severity following an evoking source. Women who reported directly experiencing sexual trauma (N = 102) completed self-report measures of metacognitive beliefs and covariates during an online study session, and subsequently completed a task that evoked mental contamination during a follow-up in-person study session. Metacognitive beliefs surrounding the uncontrollability and danger of thoughts, cognitive confidence, and the need to control thoughts positively correlated with mental contamination severity following the evoking source. Metacognitive beliefs surrounding the uncontrollability and danger of thoughts predicted greater mental contamination severity following the evoking source in multivariate analyses that statistically controlled for baseline mental contamination severity, trait anxiety, and overlap among the metacognitive beliefs. The present results provide preliminary support for the S-REF model as a potential framework for conceptualizing mental contamination.

Sleep quality affects cognitive functioning in returning combat veterans beyond combat exposure, PTSD, and mild TBI history.

OBJECTIVE: The purpose of this study was to determine how sleep quality affects cognitive functioning in returning combat veterans after accounting for effects of combat exposure, posttraumatic stress disorder (PTSD), and mild traumatic brain injury (mTBI) history. METHOD: This was a cross-sectional assessment study evaluating combat exposure, PTSD, mTBI history, sleep quality, and neuropsychological functioning. One hundred and nine eligible male Iraq/Afghanistan combat veterans completed an assessment consisting of a structured clinical interview, neuropsychological battery, and self-report measures. RESULTS: Using partial least squares structural equation modeling, combat experiences and mTBI history were not directly associated with sleep quality. PTSD was directly associated with sleep quality, which contributed to deficits in neuropsychological functioning independently of and in addition to combat experiences, PTSD, and mTBI history. Combat experiences and PTSD were differentially associated with motor speed. CONCLUSIONS: Sleep affected cognitive function independently of combat experiences, PTSD, and mTBI history. Sleep quality also contributed to cognitive deficits beyond effects of PTSD. An evaluation of sleep quality may be a useful point of clinical intervention in combat veterans with cognitive complaints. Improving sleep quality could alleviate cognitive complaints, improving veterans' ability to engage in treatment. (PsycINFO Database Record

Neuropsychological functioning, coping, and quality of life among returning war veterans.

PURPOSE: The present research tested the hypothesis that action- and emotion-focused coping strategies would mediate the relationship between neuropsychological functioning and quality of life among a sample of returning Iraq/Afghanistan veterans. METHOD: Veterans (N = 130) who served as part of the wars in Iraq and Afghanistan completed a diagnostic assessment of PTSD, a battery of questionnaires assessing coping style, traumatic brain injury (TBI), and quality of life, and neuropsychological tests measuring attention, learning and memory, working memory, inhibition, executive control, and visual motor coordination. RESULTS: Executive control, immediate and delayed verbal recall, and visual motor coordination were associated with quality of life. However, after controlling for the effects of combat exposure, PTSD, and probable TBI, no measure of neuropsychological functioning was directly associated with quality of life. Mediation analyses indicated that delayed verbal recall influenced quality of life through its effect on action-focused coping. CONCLUSIONS: Although replication is needed, these findings indicate that delayed verbal recall may indirectly influence quality of life among Iraq/Afghanistan veterans through its association with action-focused coping strategies. Psychologists who are working with veterans that are experiencing memory difficulties and poor quality of life may consider focusing on improving coping skills prior to rehabilitation of memory deficits. (PsycINFO Database Record

Distress Tolerance and Impulsivity Are Associated With Drug and Alcohol Use Consequences in an Online Community Sample.

Impulsivity and distress tolerance (DT) have been implicated as key features in development and maintenance of substance use disorders. This study expanded on previous research by exploring the four factors of DT (Absorption, Appraisal, Regulation, Tolerance) and their interaction with impulsivity in relation to substance use. Participants were 105 men and 150 women who completed measures of impulsivity, DT, and substance use. Results indicated that Appraisal DT was a better predictor of substance use problems over and above overall DT or other DT factors. Mediation analysis indicated that Appraisal partially mediated the relationship between impulsivity and DT. Results suggest that DT, particularly Appraisal, plays a role in substance use problems, specifically in the relationship between impulsivity and substance use problems. Treatments emphasizing DT skills, particularly the appraisal of aversive emotions, may be useful to employ when attempting to reduce harmful drinking or drug use behaviors.

Problematic internet use and internet searches for medical information: the role of health anxiety.

Individuals frequently use the Internet to search for medical information. For some individuals, repeated searches for medical information on the Internet exacerbate health anxiety. Researchers have termed this phenomenon "cyberchondria" and have suggested that cyberchondria might relate to the excessive use of the Internet for other purposes as well. The present study examined associations among Internet searches for medical information, health anxiety, and problematic Internet use (PIU) using a large sample of medically healthy community adults located in the United States (N=430). As predicted, respondents who experienced increased health anxiety following Internet searches for medical information reported significantly greater PIU than respondents for whom such searches either had no impact on or decreased their health anxiety. This effect was not attributable to the frequency of health-related online searching behavior or negative affect. Conceptual and therapeutic implications are discussed.

Urge-specific and lifestyle coping strategies of alcoholics: relationships of specific strategies to treatment outcome.

BACKGROUND: The present study examined the efficacy of various specific lifestyle and situation-specific coping skills by determining the relationship of each of these strategies to drinking outcomes. METHODS: Patients with alcohol dependence in intensive day treatment (n=165) were participating in a randomized trial of naltrexone versus placebo and adjunctive communication and coping skills training or a control treatment. The alcohol version of the Urge-Specific Strategies (USS) questionnaire and the General Strategies for Alcoholics (GSA) were administered early in treatment. The USS assesses 16 situation-specific strategies taught in cue exposure treatment, communication skills training, or relaxation/meditation training to cope with experiencing an urge to drink (e.g., think of positive and negative consequences of drinking, use mastery messages, engage in an alternative behavior); the 21-item GSA assesses lifestyle change strategies taught in communication skills training and in the general treatment program (e.g., keep busy, exercise regularly, attend 12-Step meetings, avoid high-risk situations). Alcohol use and frequency of use of the skills were assessed 6 and 12 months following treatment. RESULTS: Many specific behavioral and cognitive coping strategies were significantly related to drinking outcomes, including 13 urge-specific and 18 general lifestyle strategies, while other strategies were unrelated. CONCLUSIONS: Since some strategies taught in treatment are more effective in preventing relapse than others; treatment may be improved by focusing on these specific strategies. Since results may be limited to this population, replication is needed in more diverse settings and without medication.

Intolerance for discomfort among smokers: comparison of smoking-specific and non-specific measures to smoking history and patterns.

INTRODUCTION: Intolerance of discomfort associated with recent smoking cessation has been studied with only one smoking-specific questionnaire. The present study investigates the extent to which the previously validated Intolerance for Smoking Abstinence Discomfort Questionnaire (IDQ-S) scales share variance with (a) laboratory measures of distress tolerance (Paced Serial Addition Task and a breath-holding task) that have themselves been validated against smoking history, (b) the cold pressor task (not previously validated for smoking), and (c) an anxiety sensitivity questionnaire previously used for a similar purpose. The study then tests the hypothesis that the IDQ-S scales will have a higher correlation with smoking rate and dependence and with number and length of past smoking cessation attempts than with anxiety sensitivity or behavioral distress tolerance tasks do, since those measures are not smoking-specific. METHODS: Sixty daily smokers recruited from the community completed the measures. RESULTS: The behavioral tasks and anxiety sensitivity shared little common variance. Anxiety sensitivity correlated more highly with IDQ-S than did the behavioral tasks but only 27% of variance was shared with the IDQ-S Withdrawal Intolerance; no distress tolerance measure correlated significantly with the IDQ-S Lack of Cognitive Coping scale. Only the IDQ-S scales correlated significantly with nicotine dependence, rate and past cessation: Withdrawal Intolerance with nicotine dependence and rate, and Lack of Cognitive Coping with fewer quit attempts. CONCLUSIONS: The smoking-specific measure of intolerance for discomfort may be more useful in smoking research than the less specific measures of distress tolerance.

Childhood impulsive behavior and problem gambling by adulthood: a 30-year prospective community-based study.

AIMS: Problem gambling can create major financial, emotional and sometimes criminal problems for an individual. This study prospectively investigated the association between impulsive behavior at age 7 and the development of life-time problem gambling by adulthood. We also examined the specificity of any observed association between impulsive behaviors and problem gambling by conducting parallel analyses examining the link between respondents' shy/depressed behavior in childhood and later problem gambling. DESIGN, SETTING AND PARTICIPANTS: Cohort study of 958 offspring of mothers enrolled in the Collaborative Perinatal Project who participated in an adult follow-up study at a mean age of 39.2 years. MEASUREMENTS: Multivariable logistic regression models were fitted to determine associations between psychologist-rated impulsive and shy/depressed behaviors at age 7 and life-time self-reported gambling as measured by the South Oaks Gambling Screen administered during the adult follow-up study. FINDINGS: Children who exhibited impulsive behaviors at age 7, compared to their non-impulsive counterparts, were 3.09 (95% confidence interval: 1.40-6.82) times as likely to report problem gambling years later. In contrast, we did not find a significant association between childhood shy/depressed behavior and problem gambling by adulthood in adjusted analyses. CONCLUSIONS: Impulsive behaviors at age 7 are a specific and significant risk factor for later problem gambling.

Hypnosis in the treatment of Morgellons disease: a case study.

Morgellons Disease is a condition involving painful skin lesions, fibrous growths protruding from the skin, and subcutaneous stinging and burning sensations, along with symptoms of anxiety, depression, fatigue, and memory and attention deficits. The etiological and physiological bases of these symptoms are unclear, making the diagnosis controversial and challenging to treat. There are currently no established treatments for Morgellons Disease. The following case example depicts treatment of a woman with Morgellons Disease using hypnotherapy. Data from this case example suggest that hypnotherapy is a promising intervention for the physical and psychological symptoms associated with Morgellons Disease.

Executive dysfunction as a risk marker for substance abuse: the role of impulsive personality traits.

The relationships between family history of substance use, executive functions, impaired decision making, and current substance dependence are the focus of this study. Thirty-eight substance-dependent inpatients were compared with 30 community controls on performance on the Wisconsin Card Sorting Test, Trail-Making Test-B, the Stroop Color Word Test, the Wais-II Digit Span, and the Iowa Gambling Task. Recent alcohol use, depressive symptoms, and impulsivity were also assessed. As hypothesized, individuals with substance dependence exhibited poorer executive functioning. Family history status was modestly related to impaired performance on tests designed to measure the integrity of the dorsolateral prefrontal cortex. In particular, substance-dependent, family history positive individuals performed less well on the Wisconsin Card Sorting Test than substance-dependent individuals without a family history. Digit Span performances were worse among family history positive controls when compared with family history negative controls. Impulsive personality traits--specifically, difficulty thinking before acting (Urgency)--were related, as hypothesized, to executive functioning. Results indicate that family history status confers an increased risk of impairment beyond that conferred by recent substance abuse, and that impulsive personality traits are related to performance on tests of executive functions. Implications for criminality are discussed.

Self-efficacy for cocaine abstinence: pretreatment correlates and relationship to outcomes.

Little research has been conducted on the relationship of self-efficacy at treatment entry to individual differences or to treatment outcome for patients with cocaine dependence. Those relationships were examined in 163 cocaine-dependent patients in a residential treatment program using two measures of self-efficacy administered in the first week of treatment: beliefs about success in quitting in general and confidence about not using in 11 cocaine-specific high-risk situations. The most robust correlates of self-efficacy were greater desire to stop using and lower urge to use in high-risk situations. Age, depressive symptoms, cognitive functioning, recent substance use, and past success with quitting also correlated with self-efficacy. Both measures of self-efficacy predicted quantity and frequency of cocaine use and abstinence at 3 but not 6 months after treatment after controlling pretreatment cocaine use. Results suggest that treatments should target self-efficacy in cocaine-dependent patients.

Neuropsychological deficits are associated with smoking cessation treatment failure in patients with schizophrenia.

Schizophrenics have deficits in neuropsychological performance, some of which are modified by cigarette smoking. These patients also have high rates of smoking and resistance to smoking cessation interventions. We examined whether the presence of neuropsychological deficits prior to smoking cessation treatment was associated with smoking cessation treatment failure in schizophrenic as compared to non-psychiatric control smokers. Neuropsychological assessments were performed prior to treatment with pharmacological agents during the course of placebo-controlled trials in schizophrenic and non-psychiatric control smokers, and included the Wisconsin Card Sorting Test (WCST), a Visuospatial Working Memory (VSWM) task, the Stroop Color Word Test (SCWT) and the Continuous Performance Test (CPT). In schizophrenics (n=32), subjects who had greater deficits in VSWM and WCST performance were significantly less likely to quit smoking, but this association was not observed in controls (n=40). Differences between quitters and non-quitters were not likely related to atypical antipsychotic treatment or differences in depressive symptoms. No associations between baseline performance on CPT or SCWT and quit status were found in either group. These preliminary data suggest that in schizophrenics, neuropsychological deficits are associated with smoking cessation treatment failure.