The Impact of Cognitive Behavioral Therapy for Substance Use Disorders on Veterans' Interpersonal Difficulties.

Background: Substance use disorders (SUDs) negatively impact veterans and their relationships with others. Although there are several evidence-based treatments for SUD symptoms, there is less research on whether reduction in SUD symptoms coincides with reduction in interpersonal difficulties. Methods: In this study we examined the relationship between SUD and relationships in a national sample of 458 veterans who received approximately 12 sessions of Cognitive Behavioral Therapy for Substance Use Disorders (CBT-SUD) through the Veterans Health Administration (VHA). Results: Parallel latent growth curve modeling (LGCM) indicated that self-reported alcohol use, drug use, and interpersonal difficulties decreased over the course of treatment. Alcohol and drug use were positively associated with each other and with interpersonal difficulties at each time point, and baseline alcohol and drug use were negatively associated with the reduction of use over time. However, there was little evidence that reductions in substance use led to a reduction in interpersonal difficulties (or vice-versa). Conclusions: Findings highlight promising strategies to further understand how CBT-SUD may enhance reductions in substance use as well as improve relationships with family and friends.

"Is it us or is it me?": Family experiences of connectedness following a reflecting team intervention.

The present study examined family-wide versus individual perceptions of, and changes in, family connectedness in response to a one-time reflecting team (RT) intervention. Seventy-six families (N = 208 individuals), recruited during family therapy, completed family connectedness measures before and after the RT intervention. A subset of adults (n = 26) completed 1-week follow-up measures. Three-level (family, individual, time) multilevel models were used to partition sources of variance in connectedness while permitting different fixed and random effects for adults and minors. Results indicate that family connectedness is a characteristic of whole-families (34% of the variance), individuals (43%), and change over time (23%), including measurement error. Additionally, participants reported higher family connectedness after the RT. This study demonstrates the importance of considering family connectedness as a multilevel relationship construct that potentially changes in response to RT.

Alcohol Use and Risk Factors for Sexual Aggression: Differences According to Relationship Status.

The present study examined the ways alcohol use and risk factors for sexual assault perpetration vary by relationship status. Participants included 242 college men (age = 18-22 years) from a northeastern university who identified as being single or in a casual or committed dating relationship with a female partner. ANCOVAs and paired t tests compared individuals who were single, casually dating, and in committed relationships on self-reported alcohol use during sexual situations, beliefs about sexual communication, behavior associated with sexual aggression, and peer approval of sexual aggression. Differences in alcohol use during sexual situations and behavior associated with sexual aggression according to relationship status emerged. Post hoc analyses examining whether alcohol use during sexual situations moderated significant associations between relationship status and behavior associated with sexual aggression suggested that men in committed relationships who endorsed more frequent alcohol use during sexual situations also endorsed more behavior associated with sexual aggression. Findings suggest that individuals in committed relationships who often use alcohol during sexual situations may be at increased risk of sexually aggressive behavior.

Oxytocin-enhanced group therapy for methamphetamine use disorder: Randomized controlled trial.

BACKGROUND: Methamphetamine (METH) use is a public health crisis that disproportionately affects men who have sex with men (MSM). There are currently no FDA-approved pharmacological interventions to treat methamphetamine use disorder (MUD). MUD is associated with social impairments and extremely high treatment attrition rates. Administration of oxytocin, a neuropeptide involved in social attachment, may be a novel approach to addressing these issues. Moreover, oxytocin administration has shown promise for reducing METH-related addictive behavior in animal models, but has not yet been investigated in clinical trials for MUD. Last, oxytocin is known to modulate stress responsivity via regulation of the autonomic nervous system, which is dysregulated in METH users. We hypothesize that oxytocin, in combination with group psychotherapy, will increase treatment engagement, reduce addiction behavior, and mitigate stress hyperreactivity. METHODS: This is a randomized, double blind trial of oxytocin 40-IU (n = 24) or placebo (n = 24) administered intranasally prior to each of six weekly motivational interviewing group therapy (MIGT) sessions for MUD in MSM. PRIMARY OUTCOME: (a) session attendance. SECONDARY OUTCOMES: (b) group cohesion, (c) anxiety, (d) METH craving, (e) METH use, and (f) in-session cardiac physiology. RESULTS: Participants receiving oxytocin had significantly higher group therapy attendance than those receiving placebo, OR 3.26, 95% CI [1.27-8.41], p = .014. There was a small effect of oxytocin on group cohension, but not anxiety or craving. METH use did not change over the six-week MIGT course in either treatment arm. Participants receiving oxytocin had lower average heart rates during MIGT sessions and higher heart rate variability. There were positive main effects of MIGT over Time regardless of study drug. CONCLUSIONS: This evidence, and the lack of any serious adverse events, suggests that oxytocin may safely increase treatment attendance. One possible mechanism by which it may do so is its modulation of the autonomic nervous system. Further investigation is warranted.

Effectiveness of a Theory-Based mHealth Intervention for High-Risk Drinking in College Students.

Background: College students are among the most vulnerable groups to problems associated with high-risk drinking consequences such as illness, injury, sexual abuse, and death. Promising mobile health (mHealth) approaches, such as smartphone (SP) apps, can be used in interventions to address or prevent excessive drinking. Method: The aim of the investigation was to examine the efficacy of a theoretically based mHealth SP app for alcohol intervention in two independent samples (N = 379): Mandated participants (Study 1) and voluntary participants (Study 2). Study 1 included a controlled trial with Mandated participants randomized into either an in-person Brief Motivational Interviewing BMI (n = 70) or BMI + SP app intervention (n = 71). Study 2 included Voluntary participants who participated in either a Control group (n = 157) or the BMI + SP app intervention (n = 81). Participants in both studies completed baseline and 6-week assessments. Results: In Study 1, peak Blood Alcohol Concentration (BAC) of participants in the in-person BMI group had increased slightly at six weeks, while it had decreased for the app-based BMI + SP group. Study 2 participants using the BMI + SP app reported significant reductions in drinking and consequences; there were no changes in the (AO) Control group. Conclusions: The BMI + SP app was effective with both Mandated and Voluntary participants. Future testing with the BMI + SP app is needed to assess whether reach, adoptability, portability, and sustainability are greater with the mHealth smartphone app for alcohol intervention than in-person approaches.

Adolescents' Sexual Encounters With Either Romantic or Casual Partners and the Quality of Their Romantic Relationships Four Years Later.

Adolescent sexual behavior was examined within a health perspective. Assuming a developmental perspective, the current study investigated the associations between sexual behavior in either stable relationships or in casual encounters, and the quality of romantic relationships and affect 4 years later. Data were collected from 144 Israeli adolescents aged 16-18 years (mean age 16.57 years). Participants completed diary data over a period of 10 days and reported on the quality of their romantic encounters and their emotions, and on their sexual behavior in stable relationships or casual encounters. Four years later, they were asked to complete diary data again for 10 consecutive days and report on the quality of their romantic relationships and their positive and negative affect. Findings indicate that involvement in sexual behavior in stable romantic relationships was associated only with future romantic partner support. In contrast, earlier involvement in casual sexual behavior was associated with a number of future indices: lower partner support, greater negative affect as well as greater relationship tension, and dyadic hurtful behavior 4 years later. The differential role of sexuality within a stable relationship or casual encounters among adolescents for their future romantic development is discussed within a developmental framework.

Improvement in therapist skills over sessions in brief motivational interventions predicts client language and alcohol use outcomes.

Brief motivational interventions (BMIs) are widely used and efficacious interventions that address alcohol misuse in mandated college students. Consistent with motivational interviewing (MI; Miller & Rollnick, 2013) theory, within-therapist improvements in MI-consistent (MICO) skills over time-that is, as a therapist gains skill through repeated practice-may be associated with concurrent increases in client change language and subsequent changes in behavior. This study examined how therapist skill changed over time and whether within-therapist improvement in MICO skills impacted in-session client change language and subsequent alcohol-related outcomes. BMI sessions (N = 228) from 2 randomized clinical trials that had led to significant reductions in alcohol use and alcohol-related problems in mandated student drinkers were coded using the Motivational Interviewing Skills Code 2.0 (Miller, Moyers, Ernst, & Amrhein, 2003). In both studies, the BMI consisted of a single 45- to 60-min session. Analyses examined session-by-session changes in therapist MICO skills, client change language, and alcohol use outcomes. Therapist MICO skills improved over time, and there were significant increases in client change language and decreases in client discussion of topics other than personal alcohol use. Among relatively heavy-drinking clients, those treated by a more experienced therapist demonstrated greater reductions in alcohol use; however, this association was not mediated by client change language. Increased experience conducting BMIs improved therapist MICO skills over time, which in turn increased the focus on personal alcohol use during the session. However, it remains unclear how client language predicts behavior change following a BMI. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Looking into the One-way Mirror: A Pilot Study on the Impact of Reflecting Teams on Family Members.

Reflecting Teams (RTs) are an internationally recognized clinical consultation methodology, first developed by Tom Andersen in 1985. Over the last three decades, family therapists around the world have used RTs to enhance treatment. However, this innovation to family therapy practice is not well-standardized nor evaluated. The pilot study described in this article is an attempt to expand on the previous studies on RTs, and quantitatively examines RTs conducted with family therapy participants at a university medical center psychiatric institute. Preliminary analyses indicate that after participating in a single RT, family members may feel more hopeful, believe they can better support each other in times of stress, have more confidence in working together, and resolve conflicts. Additionally, the analyses suggest that family members may feel better understood and have more ideas about how to have a conversation with their family members, even though, after the RT, they may not view their family differently. These preliminary results suggest that further studies should explore the influence of RTs on family functioning.

Los "equipos reflexivos" (Reflecting Teams, RTs) son una metodología de consulta clínica reconocida a nivel internacional que fue desarrollada por primera vez por Tom Andersen en 1985 (Andersen, 1992). Durante las últimas tres décadas, los terapeutas familiares de todo el mundo han usado los equipos reflexivos para optimizar el tratamiento (p. ej.: Brownlee, Vis, & McKenna, 2009; Höger, Temme, Reiter, & Steiner, 1994). Sin embargo, esta innovación en la práctica de terapia familiar no está bien estandarizada ni evaluada. El estudio piloto descrito en este artículo es un intento de ampliar estudios previos sobre los equipos reflexivos y de analizar cuantitativamente los equipos reflexivos implementados con los participantes de una terapia familiar en un instituto psiquiátrico y un centro médico universitario. Los análisis preliminares indican que después de participar en un solo equipo reflexivo, los familiares pueden sentirse más optimistas, creer que pueden apoyarse mejor mutuamente en momentos de estrés, tener más confianza en trabajar juntos y resolver conflictos. Los integrantes de la familia también pueden sentirse mejor comprendidos y tener más ideas acerca de cómo conversar con sus familiares. Sin embargo, después del equipo reflexivo, es posible que no vean a su familia de forma diferente. Estos resultados preliminares sugieren que otros estudios deberían analizar la influencia de los equipos reflexivos en el funcionamiento familiar.

How Do College Experience and Gender Differentiate the Enactment of Hookup Scripts Among Emerging Adults?

Empirical attention to "hooking up" has expanded over time, yet limited attention has been devoted to understanding the hookup experiences of emerging adults (ages 18-25) who have not attended college and how they may differ from those who have attended college. Guided by life course and scripting theories, we used a storytelling methodology to content analyze the hookup stories of a large sample of college-attending and non-college emerging adults (N = 407). We also compared stories based on gender, as several studies report gender differences but have yet to consider how hookup scripts may differ between men and women. Overall, we found that college-attending and non-college emerging adults reported using similar hookup scripts in their most recent hookup experience, as did emerging adult men and women. However, we found that greater proportions of non-college emerging adults reported sexual touch, meeting in an "other location," and positive reactions to their most recent hookup. Greater proportions of college-attending emerging adults reported their hookup occurred in a house/apartment. In terms of gender, greater proportions of women reported "having sex" and deep kissing, hooking up with an acquaintance, partner characteristics as a reason to hookup, and negative reactions to their most recent hookup. Greater proportions of men reported hooking up with a stranger, meeting at a bar/club, hooking up at a party, and hooking up at an "other location." Implications for future research and sexual health education and intervention are discussed.

Predicting post-breakup distress and growth in emerging adulthood: The roles of relationship satisfaction and emotion regulation.

With a sample of emerging adults (N = 110; 72% female) this brief report utilized self-report measures to examine the role of relationship satisfaction and emotion regulation strategies assessed at age 20 in predicting breakup distress and posttraumatic growth three years later. Results showed that higher relationship satisfaction is associated with less future breakup distress. Emotion regulation explained the ways individuals cope with distress; cognitive appraisal (in contrast to emotional suppression) predicted higher growth after experiencing a breakup. Findings highlight the ways emotion regulation strategies can help emerging adults cope with relational stressors such as breakups.

Changes in rejection sensitivity across adolescence and emerging adulthood: Associations with relationship involvement, quality, and coping.

Using a sample of 110 Israeli youth (72% female), the present study investigates associations between initial levels of rejection sensitivity as well as changes in rejection sensitivity from age 16 to age 23 and relationship involvement, quality, and (growth following) coping with relationship stress. Results showed that rejection sensitivity generally decreased over time into the transition to adulthood. Furthermore, levels of rejection sensitivity at age 16 predicted whether young people were romantically involved by age 23, as well as the quality of their relationships. Yet, the change in level of rejection sensitivity over time explained far more the quality of later romantic relationships and competence in coping with relationship stress than the initial level of rejection sensitivity. These findings have important implications for examining the role of changes in personality attributes such as rejection sensitivity in the transition from adolescence to adulthood.

Betrayals in Emerging Adulthood: A Developmental Perspective of Infidelity.

Infidelity is associated with considerable distress and discord in dating relationships. The current mixed methods study examined both the written narratives and survey responses of 104 (59.6% women) emerging adults to investigate reasons for engaging in infidelity (i.e., sexual and emotional infidelity). Emerging adults' reasons for engaging in infidelity were attributed primarily to their primary relationships and/or their romantic partners not fulfilling their needs for interdependence and thus feeling motivated to fulfill these needs elsewhere. Although the majority of participants provided independence and/or interdependence reasons for their infidelity, a large proportion of responses (40%) referenced alternative reasons. These responses included (a) the opportunity to become intimate with an infidelity partner while under the influence of alcohol, (b) attraction to an infidelity partner, and (c) the excitement and novelty that the infidelity experience provided. Those who reported engaging in infidelity because of unmet interdependence needs, and intimacy needs in particular, were more avoidantly attached than those who did not reference unmet interdependence needs. Those who reported engaging in infidelity because of unmet independence needs were more anxiously attached than those who did not reference unmet independence needs. Implications for the developmental importance of infidelity in terms of research and applied work are discussed.

The Symbolic Nature of Trust in Heterosexual Adolescent Romantic Relationships.

Trust contributes to young people's capacity for sustaining current and future successful relationships. To date, research has yet to examine the meaning of trust in early dating relationships and reasons for its deterioration. The present study focused on video-recorded conversations about trust between 34 heterosexual adolescent couples in dating relationships living in the U.S. Transcripts from these conversations were qualitatively analyzed using thematic analysis to identify adolescents' meanings of trust and reasons they provided for a lack of trust in their romantic partners. All 34 couples identified concerns specifically related to infidelity. Six major themes for not trusting romantic partners emerged. Results suggested that the lack of trust in romantic relationships might stem from several areas that are directly and indirectly related to the current relationship, including low self-esteem, the experience of betrayal in past romantic relationships, partners' extradyadic behaviors, and gossip among peers. Importantly, peers can play a defining role in influencing young people's perceptions of their romantic partners and developing or sustaining trust in their romantic relationships.

Rejection sensitivity and depressive symptoms: Longitudinal actor-partner effects in adolescent romantic relationships.

The present study utilizes the actor-partner interdependence model to examine the longitudinal relationship between rejection sensitivity and one's own and one's partner's depressive symptoms. The sample included adolescent romantic couples from the U.S. (N = 198 adolescents; 50% girls; 90.2% Caucasian) whose rejection sensitivity at Time 1 and depressive symptoms approximately one year later (Time 2) were assessed. Additionally, aggressive behaviors and maintenance behaviors that commonly associated with rejection sensitivity (e.g., self-silencing) are explored as mediators. Results indicate that boyfriends' rejection sensitivity at Time 1 predicted girlfriends' depressive symptoms at Time 2. Additionally, girls' rejection sensitivity predicted their own and their boyfriends' self-silencing. Developmental and clinical implications are discussed.

Rejection sensitivity and adolescents' perceptions of romantic interactions.

Rejection sensitivity - the tendency to expect, perceive, and overreact to rejection by others - is linked with individuals' expectations that their romantic partners' behaviors have negative intent, even if, perhaps, such behaviors could be considered neutral when observed by another. The aim of the present study was to test this proposition, derived from rejection sensitivity theory, using a Video-Recall Procedure with adolescent couples in the US (N = 386 adolescents, 50% girls). We examined whether adolescents who were more sensitive to rejection perceived their romantic partners' behaviors as more conflictual than when viewed by trained, third-party observers. Findings suggest that, at the micro-analytic level, higher rejection sensitivity is associated with adolescents' heightened perception of their romantic partners as conflictual when compared to observers, who more often coded the same behaviors as neutral rather than conflictual. Implications for adolescent mental health and well-being are discussed.