Contributions of Demand/Withdraw Processes and Alcohol Consumption on Emotional Flooding in Distressed Violent versus Distressed Non-Violent Couples.

Purpose: Although alcohol-related intimate partner violence (IPV) is a serious public health problem, the mechanisms underlying this association are poorly understood. For instance, prior research has shown differences in distressed violent (DV) and distressed nonviolent (DNV) couples' demand/withdraw communication and the extent to which they become emotionally flooded (i.e., physiologically aroused) in response to conflict. Additionally, alcohol use is associated with increased demand/withdraw communication, IPV, and emotional flooding. Therefore, the present study sought to clarify the association between demand/withdraw communication and emotional flooding among relationally couples who use alcohol and who do and do not experience IPV. Methods: Relationally distressed couples (Mage =30.1 years) reported on their physical aggression, demand/withdraw communication, emotional flooding, and total number of drinks during the past six months. Couples were denoted as DV (N = 58) if at least one partner reported IPV and DNV (N = 29) if neither partner reported IPV. Actor-partner interdependence modeling was used to test whether couple type (DV versus DNV) moderates the link between demand/withdraw behavior and emotional flooding. Results: With one exception, alcohol use was unrelated to any of the processes under investigation in the current study. Moreover, men's and women's report of a woman-demand/man-withdraw pattern and man-demand/woman-withdraw pattern, respectively, were positively associated with each partner's own emotional flooding. Couple type (DV vs DNV) did not moderate these associations. Conclusions: The present results highlight the need for sensitive measures that can capture the nuanced processes that underlie IPV in couples who use alcohol.

Event-related Potentials Corresponding to Decision-making Under Uncertain Conditions.

BACKGROUND: Decision-making is essential to human functioning, and resolving uncertainty is an essential part of decision-making. Impaired decision-making is present in many pathological conditions, and identifying markers of decision-making under uncertainty will provide a measure of clinical impact in future studies of therapeutic intervention for impaired decision-making. OBJECTIVE: To describe EEG event-related potentials (ERPs) correlating with decision-making under uncertain conditions when compared with certain conditions. METHOD: We used a novel card-matching task based on the Wisconsin Card Sorting Test to describe the neural correlates of uncertainty, as measured by EEG, in a group of 27 neurotypical individuals. We evaluated 500-ms intervals in the 2 seconds after card presentation to identify ERPs that are associated with maximal uncertainty compared with maximal certainty. RESULTS: After correcting for multiple comparisons, we identified an ERP in the 500-1000-ms time frame (certain > uncertain, max amplitude 12.73 µV, latency 914 ms) in the left posterior inferior region of the scalp. We also found a P300-like ERP in the left frontal and parietal regions in the 0-500-ms time frame when the individuals received correct versus incorrect feedback (incorrect feedback > correct feedback, max amplitude 1.625 µV, latency 339 ms). CONCLUSION: We identified an ERP in the 500-1000-ms time frame (certain > uncertain) that may reflect the resolution of uncertainty, as well as a P300-like ERP when feedback is presented (incorrect feedback > correct feedback). These findings can be used in future studies to improve decision-making and resolve uncertainty on the described markers.

Heart rate variability may index emotion dysregulation in alcohol-related intimate partner violence.

Introduction: Intimate partner violence is a serious public health problem that costs the United States more than $4.1 billion in direct medical and mental health costs alone. Furthermore, alcohol use contributes to more frequent and more severe intimate partner violence incidents. Compounding this problem is treatments for intimate partner violence have largely been socially informed and demonstrate poor efficacy. We argue that improvements in intimate partner treatment will be gained through systematic scientific study of mechanisms through which alcohol is related to intimate partner violence. We hypothesize that poor emotional and behavioral regulation as indexed by the respiratory sinus arrythymia measure of heart rate variability is a key mechanism between alcohol use and intimate partner violence. Method: The present study is a placebo-controlled alcohol administration study with an emotion-regulation task that investigated heart rate variability in distressed violent and distressed nonviolent partners. Results: We found a main effect for alcohol on heart rate variability. We also found a four-way interaction whereby distressed violent partners exhibited significant reductions in heart rate variability when acutely intoxicated and attempting to not respond to their partners evocative stimuli. Discussion: These findings suggest that distressed violent partners may adopt maladaptive emotion regulation strategies such as rumination and suppression when intoxicated and attempting to not respond to partner conflict. Such strategies of emotion regulation have been shown to have many deleterious emotional, cognitive and social consequences for individuals who adopt them, possibly including intimate partner violence. These findings also highlight an important novel treatment target for intimate partner violence and suggest that novel treatments should focus on teaching effective conflict resolution and emotion-regulation strategies that may be augmented by biobehavioral treatments such as heart rate variability biofeedback.

A randomized pilot trial of brief family-involved treatment for alcohol use disorder: Treatment engagement and outcomes.

OBJECTIVE: Involving family members in a patient's treatment for alcohol use disorder (AUD) leads to more positive outcomes, but evidence-based family-involved treatments have not been adopted widely in AUD treatment programs. Study aims the following: (a) modify an empirically supported 12-session AUD treatment, alcohol behavioral couple therapy (ABCT) to make it shorter and appropriate for any concerned family member and (b) conduct a small clinical trial to obtain feasibility data and effect size estimates of treatment efficacy. METHOD: ABCT content was adapted to three-sessions following input from clinicians, patients, and family members. Patient and family member dyads were recruited from an inpatient treatment program and randomized to the new treatment, brief family-involved treatment (B-FIT), or treatment-as-usual (TAU). Drinking was assessed using the Form-90; family support and family functioning were assessed using the Family Environment Scale Conflict and Cohesion subscales and the Family Adaptability and Cohesion Evaluation Scale-IV, Communication scale. Dyads (n = 35) were assessed at baseline and 4-month follow-up. RESULTS: On average, dyads received one of three B-FIT sessions with 6 dyads receiving no sessions due to scheduling conflicts or patient discharge. At follow-up, there was a large-to-medium effect size estimate favoring B-FIT for proportion drinking days (patient report, n = 22; Hedges' g = 1.01; patient or family report, n = 28; Hedges' g = .48). Results for family support or family functioning measures favored TAU. CONCLUSIONS: Implementation of brief family-involved treatment in inpatient AUD treatment was challenging, but preliminary data suggest the potential value of B-FIT in impacting drinking outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An Effective Intervention: Limiting Opioid Prescribing as a Means of Reducing Opioid Analgesic Misuse, and Overdose Deaths.

Overdose deaths involving prescription opioids killed more than 17,000 Americans in 2017, marking a five-fold increase since 1999. High prescribing rates of opioid analgesics have been a substantial contributor to prescription opioid misuse, dependence, overdose and heroin use. There was recognition approximately ten years ago that opioid prescribing patterns were contributing to this startling increase in negative opioid-related outcomes, and federal actions, including Medicare reimbursement reform and regulatory actions, were initiated to restrict opioid prescribing. The current manuscript is a description of those actions, the effect of those actions on opioid prescribing and related patient outcomes. We also describe our proposal of methods of expanding these efforts as an important piece to further reduce opioid-related misuse, dependence, and overdose death.

Father's Involvement When Bringing Baby Home: Efficacy Testing of a Couple-Focused Transition to Parenthood Intervention for Promoting Father Involvement.

The goal of the present research was to test the efficacy of the Bringing Baby Home couple-focused psychoeducational program for promoting father involvement and related satisfaction. A randomized clinical trial design was used to randomly assign 136 pregnant couples to either an intervention or control group. Father involvement post-intervention was assessed through self-report of engagement in parenting tasks. Intent-to-treat analysis of covariance analyses indicated that fathers who participated in the Bringing Baby Home program reported significantly more involvement in parenting tasks, satisfaction with the division of parenting labor, and feeling appreciated by their wives. Both husbands and wives were also more satisfied with the division of labor when fathers were more involved in parenting. Results suggest that couple-focused psychoeducational programs can be successful for promoting father involvement.

Frontal alpha asymmetry in alcohol-related intimate partner violence.

Electroencephalographic (EEG) frontal alpha asymmetry (FAA) has been associated with differences in the experience and expression of emotion, motivation and anger in normal and clinical populations. The current study is the first to investigate FAA in alcohol-related intimate partner violence. EEG was recorded from 23 distressed violent (DV) and 15 distressed nonviolent (DNV) partners during a placebo-controlled alcohol administration and emotion-regulation study. The State-Trait Anger Expression Inventory 2 was used to evaluate anger experiences and was collected from both participants and their partners. During baseline, acute alcohol intoxication DV partners had significantly greater right FAA, whereas DNV partners showed greater left FAA. Both partner types demonstrated significantly greater right FAA during the placebo beverage condition of the emotion-regulation task when viewing evocative partner displays of contempt, belligerence, criticism, defensiveness and stonewalling, but greater left FAA during acute alcohol intoxication. Although no group differences were found in the emotion-regulation task, partner self-reported anger experiences accounted for 67% of the variance in the FAA of DV participants when intoxicated and viewing evocative stimuli, suggesting dyadic processes are important in understanding alcohol-related IPV. These findings suggest that FAA could index the affective and motivational determinants through which alcohol is related to IPV.

Social Order: Using The Sequential Structure of Social Interaction to Discriminate Abnormal Social Behavior in the Rat.

Social interactions form the basis of a broad range of functions related to survival and mating. The complexity of social behaviors and the flexibility required for normal social interactions make social behavior particularly susceptible to disruption. The consequences of developmental insults in the social domain and the associated neurobiological factors are commonly studied in rodents. Though methods for investigating social interactions in the laboratory are diverse, animals are typically placed together in an apparatus for a brief period (under 30 min) and allowed to interact freely while behavior is recorded for subsequent analysis. A standard approach to the analysis of social behavior involves quantification of the frequency and duration of individual social behaviors. This approach provides information about the allocation of time to particular behaviors within a session, which is typically sufficient for detection of robust alterations in behavior. Virtually all social species, however, display complex sequences of social behavior that are not captured in the quantification of individual behaviors. Sequences of behavior may provide more sensitive indicators of disruptions in social behavior. Sophisticated analysis systems for quantification of behavior sequences have been available for many years; however, the required training and time to complete these analyses represent significant barriers to high-throughput assessments. We present a simple approach to the quantification of behavioral sequences that requires minimal additional analytical steps after individual behaviors are coded. We implement this approach to identify altered social behavior in rats exposed to alcohol during prenatal development, and show that the frequency of several pairwise sequences of behavior discriminate controls from ethanol-exposed rats when the frequency of individual behaviors involved in those sequences does not. Thus, the approach described here may be useful in detecting subtle deficits in the social domain and identifying neural circuits involved in the organization of social behavior.

Machine Learning of Functional Magnetic Resonance Imaging Network Connectivity Predicts Substance Abuse Treatment Completion.

BACKGROUND: Successfully treating illicit drug use has become paramount, yet elusive. Devising specialized treatment interventions could increase positive outcomes, but it is necessary to identify risk factors of poor long-term outcomes to develop specialized, efficacious treatments. We investigated whether functional network connectivity (FNC) measures were predictive of substance abuse treatment completion using machine learning pattern classification of functional magnetic resonance imaging data. METHODS: Treatment-seeking stimulant- or heroin-dependent incarcerated participants (n = 139; 89 women) volunteered for a 12-week substance abuse treatment program. Participants performed a response inhibition Go/NoGo functional magnetic resonance imaging task prior to onset of the substance abuse treatment. We tested whether FNC related to the anterior cingulate cortex would be predictive of those who would or would not complete a 12-week substance abuse treatment program. RESULTS: Machine learning pattern classification models using FNC between networks incorporating the anterior cingulate cortex, striatum, and insula predicted which individuals would (sensitivity: 81.31%) or would not (specificity: 78.13%) complete substance abuse treatment. FNC analyses predicted treatment completion above and beyond other clinical assessment measures, including age, sex, IQ, years of substance use, psychopathy, anxiety and depressive symptomatology, and motivation for change. CONCLUSIONS: Aberrant neural network connections predicted substance abuse treatment outcomes, which could illuminate new targets for developing interventions designed to reduce or eliminate substance use while facilitating long-term outcomes. This work represents the first application of machine-learning models of FNC analyses of functional magnetic resonance imaging data to predict which substance abusers would or would not complete treatment.

Investigating error-related processing in incarcerated adolescents with self-report psychopathy measures.

Disparate results have been found in previous reports when incorporating both interview-based and self-report measures of psychopathic traits within the same sample, suggesting such assessments should not be used interchangeably. We previously found Total and Facet 4 scores from Hare's Psychopathy Checklist: Youth Version (PCL:YV) were negatively related to amplitude of the error-related positivity (Pe) event-related potential (ERP) component. Here, we investigated using the same previously published sample whether scores on four different self-report measures of adolescent psychopathic traits (the Antisocial Process Screening Device [APSD], Child Psychopathy Scale [CPS], Inventory of Callous-Unemotional Traits [ICU], and Youth Psychopathic Traits Inventory [YPI]) were similarly associated with reduced Pe amplitude. Unlike our previous results, adolescent self-report psychopathy scores were not associated with reduced Pe amplitude in multiple regression analyses. Results obtained in the current report support previous research observing incongruent findings when incorporating different assessment types within the same sample.

The Simple Video Coder: A free tool for efficiently coding social video data.

Videotaping of experimental sessions is a common practice across many disciplines of psychology, ranging from clinical therapy, to developmental science, to animal research. Audio-visual data are a rich source of information that can be easily recorded; however, analysis of the recordings presents a major obstacle to project completion. Coding behavior is time-consuming and often requires ad-hoc training of a student coder. In addition, existing software is either prohibitively expensive or cumbersome, which leaves researchers with inadequate tools to quickly process video data. We offer the Simple Video Coder-free, open-source software for behavior coding that is flexible in accommodating different experimental designs, is intuitive for students to use, and produces outcome measures of event timing, frequency, and duration. Finally, the software also offers extraction tools to splice video into coded segments suitable for training future human coders or for use as input for pattern classification algorithms.

Brain potentials predict substance abuse treatment completion in a prison sample.

INTRODUCTION: National estimates suggest that up to 80% of prison inmates meet diagnostic criteria for a substance use disorder. Because more substance abuse treatment while incarcerated is associated with better post-release outcomes, including a reduced risk of accidental overdose death, the stakes are high in developing novel predictors of substance abuse treatment completion in inmate populations. METHODS: Using electroencephalography (EEG), this study investigated stimulus-locked ERP components elicited by distractor stimuli in three tasks (VO-Distinct, VO-Repeated, Go/NoGo) as a predictor of treatment discontinuation in a sample of male and female prison inmates. We predicted that those who discontinued treatment early would exhibit a less positive P3a amplitude elicited by distractor stimuli. RESULTS: Our predictions regarding ERP components were partially supported. Those who discontinued treatment early exhibited a less positive P3a amplitude and a less positive PC4 in the VO-D task. In the VO-R task, however, those who discontinued treatment early exhibited a more negative N200 amplitude rather than the hypothesized less positive P3a amplitude. The discontinuation group also displayed less positive PC4 amplitude. Surprisingly, there were no time-domain or principle component differences among the groups in the Go/NoGo task. Support Vector Machine (SVM) models of the three tasks accurately classified individuals who discontinued treatment with the best model accurately classifying 75% of inmates. PCA techniques were more sensitive in differentiating groups than the classic time-domain windowed approach. CONCLUSIONS: Our pattern of findings are consistent with the context-updating theory of P300 and may help identify subtypes of ultrahigh-risk substance abusers who need specialized treatment programs.

Alcohol-Focused Behavioral Couple Therapy.

Alcohol Behavioral Couple Therapy (ABCT) has emerged over the last 30 years as a highly efficacious treatment for those with alcohol use disorders. This review highlights the historical and conceptual underpinnings of ABCT, as well as the specific treatment elements and structure. Proposed active ingredients, moderators, and mediators of treatment outcome are discussed. Efficacy is evaluated for reductions in identified patient drinking, improved relationship functioning, and reductions in intimate partner violence. Adaptations of ABCT for substances other than alcohol are described. Other adaptations, including brief interventions, interventions addressing PTSD and TBI along with alcohol use, and interventions deliverable via technology platforms are described. Additional cost-benefit and cost-effectiveness findings supporting the economic value of ABCT are noted. Future directions for research in this area include possible adaptations for female identified patients, nontraditional couples, LGBT partners and dyads involving nonintimate partner relationships. The development of more flexible models and enhanced dissemination strategies may improve clinical uptake and utility as well as increasing the feasibility of this treatment for integrated healthcare settings.

Effects of sex and housing on social, spatial, and motor behavior in adult rats exposed to moderate levels of alcohol during prenatal development.

Persistent deficits in social behavior, motor behavior, and behavioral flexibility are among the major negative consequences associated with exposure to ethanol during prenatal development. Prior work from our laboratory has linked moderate prenatal alcohol exposure (PAE) in the rat to deficits in these behavioral domains, which depend upon the ventrolateral frontal cortex (Hamilton et al., 2014) [20]. Manipulations of the social environment cause modifications of dendritic morphology and experience-dependent immediate early gene expression in ventrolateral frontal cortex (Hamilton et al., 2010) [19], and may yield positive behavioral outcomes following PAE. In the present study we evaluated the effects of housing PAE rats with non-exposed control rats on adult behavior. Rats of both sexes were either paired with a partner from the same prenatal treatment condition (ethanol or saccharin) or from the opposite condition (mixed housing condition). At four months of age (∼3 months after the housing manipulation commenced), social behavior, tongue protrusion, and behavioral flexibility in the Morris water task were measured as in (Hamilton et al., 2014) [20]. The behavioral effects of moderate PAE were primarily limited to males and were not ameliorated by housing with a non-ethanol exposed partner. Unexpectedly, social behavior, motor behavior, and spatial flexibility were adversely affected in control rats housed with a PAE rat (i.e., in mixed housing), indicating that housing with a PAE rat has broad behavioral consequences beyond the social domain. These observations provide further evidence that moderate PAE negatively affects social behavior, and underscore the importance of considering potential negative effects of housing with PAE animals on the behavior of critical comparison groups.

Examining temptation to drink from an existential perspective: Associations among temptation, purpose in life, and drinking outcomes.

Temptation to drink (TTD), defined as the degree to which one feels compelled to drink in the presence of internal or external alcohol-related cues, has been shown to predict alcohol-treatment outcomes among individuals with alcohol-use disorders (AUDs). Research examining TTD from an existential perspective is lacking and little is known about how existential issues such as purpose in life (PIL) relate to TTD, which is surprising given the role of existential issues in many treatments and mutual help approaches for AUDs. In the current study, we examined the longitudinal associations in a sample of 1726 among TTD, PIL, and drinking outcomes using data from Project MATCH (1997, 1998). Parallel process latent growth curve analyses indicated that PIL and TTD were significantly associated across time, such that higher initial levels of PIL and increases in PIL over time were associated with lower initial levels of TTD and decreases in TTD over time. Higher initial levels of TTD, lower initial levels of PIL, increases in TTD, and decreases in PIL were significantly associated with greater intensity and frequency of drinking and greater drinking-related consequences at the 15-month follow-up. Accordingly, TTD and PIL may be important constructs for clinicians to consider throughout the course of treatment. Future studies should examine if and how various kinds of treatments for AUDs are associated with increases in PIL, and whether these increases are related to decreased TTD and reduced drinking.

Short-Term Change in Couples' Conflict Following a Transition to Parenthood Intervention.

Conflict among couples was examined following a transition to parenthood intervention to determine both short-term efficacy of the program and elucidate the process of change postintervention. A randomized clinical trial design was used to examine conflict in couples who participated in a transition to parenthood psycho-educational workshop compared with controls. The beginnings of improved communication in conflict were evident at 3 months postbirth through decreased husband contempt and increased husband positive affect during conflict in a sample that demonstrated more substantial improvement at 1 year postintervention. Increases in husband positive affect in the workshop group at 3 months postbirth predicted more positive and less negative wife affect during conflict at 1 year postbirth. Results suggest that some indicators of intervention efficacy were evident, postintervention change can be gradual, husbands may be more receptive to implementing change shortly after birth, and early changes can be associated with later positive outcomes. Findings have implications for preparing couples for the gradual and complex nature of change associated with intervention.

Moderate prenatal alcohol exposure and quantification of social behavior in adult rats.

Alterations in social behavior are among the major negative consequences observed in children with Fetal Alcohol Spectrum Disorders (FASDs). Several independent laboratories have demonstrated robust alterations in the social behavior of rodents exposed to alcohol during brain development across a wide range of exposure durations, timing, doses, and ages at the time of behavioral quantification. Prior work from this laboratory has identified reliable alterations in specific forms of social interaction following moderate prenatal alcohol exposure (PAE) in the rat that persist well into adulthood, including increased wrestling and decreased investigation. These behavioral alterations have been useful in identifying neural circuits altered by moderate PAE(1), and may hold importance for progressing toward a more complete understanding of the neural bases of PAE-related alterations in social behavior. This paper describes procedures for performing moderate PAE in which rat dams voluntarily consume ethanol or saccharin (control) throughout gestation, and measurement of social behaviors in adult offspring.

Effects of moderate prenatal ethanol exposure and age on social behavior, spatial response perseveration errors and motor behavior.

Persistent deficits in social behavior are among the major negative consequences associated with exposure to ethanol during prenatal development. Prior work from our laboratory has linked deficits in social behavior following moderate prenatal alcohol exposure (PAE) in the rat to functional alterations in the ventrolateral frontal cortex [21]. In addition to social behaviors, the regions comprising the ventrolateral frontal cortex are critical for diverse processes ranging from orofacial motor movements to flexible alteration of behavior in the face of changing consequences. The broader behavioral implications of altered ventrolateral frontal cortex function following moderate PAE have, however, not been examined. In the present study we evaluated the consequences of moderate PAE on social behavior, tongue protrusion, and flexibility in a variant of the Morris water task that required modification of a well-established spatial response. PAE rats displayed deficits in tongue protrusion, reduced flexibility in the spatial domain, increased wrestling, and decreased investigation, indicating that several behaviors associated with ventrolateral frontal cortex function are impaired following moderate PAE. A linear discriminant analysis revealed that measures of wrestling and tongue protrusion provided the best discrimination of PAE rats from saccharin-exposed control rats. We also evaluated all behaviors in young adult (4-5 months) or older (10-11 months) rats to address the persistence of behavioral deficits in adulthood and possible interactions between early ethanol exposure and advancing age. Behavioral deficits in each domain persisted well into adulthood (10-11 months), however, there was no evidence that aging enhances the effects of moderate PAE within the age ranges that were studied.

Clinical processes in behavioral couples therapy.

Behavioral couples therapy is a broad term for couples therapies that use behavioral techniques based on principles of operant conditioning, such as reinforcement. Behavioral shaping and rehearsal and acceptance are clinical processes found across contemporary behavioral couples therapies. These clinical processes are useful for assessment and case formulation, as well as teaching couples new methods of conflict resolution. Although these clinical processes assist therapists in achieving efficient and effective therapeutic change with distressed couples by rapidly stemming couples' corrosive affective exchanges, they also address the thoughts, emotions, and issues of trust and intimacy that are important aspects of the human experience in the context of a couple. Vignettes are provided to illustrate the clinical processes described. (PsycINFO Database Record (c) 2014 APA, all rights reserved).