Racial Microaggressions Mediate the Association Between Posttraumatic Stress and Alcohol Use Among Women of Color Experiencing Intimate Partner Violence.

Objective: Women of Color (WoC) experiencing intimate partner violence (IPV) have elevated rates of posttraumatic stress disorder (PTSD) and alcohol use and related harm (e.g., increased alcohol use and negative consequences). This secondary data analysis assessed the role of racial microaggressions in the association between PTSD and alcohol use and related harm among WoC experiencing IPV. Methods: Participants were 103 WoC currently experiencing IPV and using substances (Mage=40.39, 51.5% Black) who were recruited from the community and completed assessments of PTSD, racial microaggressions, and alcohol use and related harm. Results: Assumptions of Inferiority (e.g., intelligence; B = 1.44, SE = 0.90, 95% CI [0.10, 3.54]) and Environmental Microaggressions (e.g., portrayal in media; B = 1.88, SE = 1.03, 95% CI [0.28, 4.30]) explained the association between PTSD and alcohol use and related harm. Conclusions: Findings underscore the influence of specific microaggressions in the relation between PTSD and alcohol use and related harm among WoC experiencing IPV.

An investigation of laboratory-based positive and negative emotional suppression in relation to posttraumatic stress disorder symptom clusters.

BACKGROUND: Emotional suppression is a clinically significant aspect of emotion regulation with robust associations to psychopathology, including posttraumatic stress disorder (PTSD). Despite the fast-growing body of literature highlighting the role of positive emotion regulation difficulties in the development and maintenance of PTSD, extant work on emotional suppression and PTSD has almost exclusively focused on the role of negative emotions. OBJECTIVE: The present study aimed to advance this literature by examining the associations between PTSD symptom clusters and participants' use of state emotional suppression during a laboratory task designed to elicit negative or positive emotions. METHOD: Participants were 108 community women (Mage = 39.55; 33% Black/African American) currently experiencing intimate partner violence (IPV) by a male partner and using substances. Participants were interviewed using a structured diagnostic assessment for PTSD and reported on state emotional intensity and emotional suppression following idiographic negative or positive emotion inductions. RESULTS: Results of the moderation analyses showed that, when controlling for state emotional intensity, women experiencing clinical levels of PTSD symptom Clusters B (intrusive recollections), D (negative alterations in cognitions and mood), and E (alterations in arousal and reactivity) were significantly more likely to utilize emotional suppression, but only in the context of positive-not negative-emotions. CONCLUSIONS: Findings provide evidence for a link between PTSD and positive emotional suppression among women currently experiencing IPV by a male partner and using substances, highlighting positive emotional suppression as a potential target in PTSD treatment for IPV populations with comorbid substance use concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Experimental Investigation of the Influence of Positive Emotion Dysregulation on Risky Behavior Following Idiographic Emotion Inductions.

An experimental paradigm with subjective and objective assessments was used to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances (Mage = 40.81, 43.0% white). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (versus negative and neutral) emotion induction conditions; and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (versus neutral) emotion induction condition. Findings provide additional support for the influence of positive emotion dysregulation on risky behavior.

Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence.

BACKGROUND: Women experiencing intimate partner violence (IPV) are at increased risk for developing hazardous patterns of cannabis use. Research suggests that women experiencing IPV use cannabis to cope with posttraumatic stress disorder (PTSD) symptoms. To advance research, we used experience sampling methods to explicate the within-day concurrent and proximal relations between PTSD symptom clusters and cannabis use among women experiencing IPV. METHOD: Participants were 145 community women (M age = 40.66, 41.6% white, 31.4% Black, 10.9% Hispanic or Latina, 8% American Indian/Alaska Native, 5.8% Bi-/multi-racial) experiencing IPV and using substances who completed three surveys a day for 30 days. RESULTS: Externalizing behavior (OR = 1.37, 95% CI [1.15, 1.65], p < 0.001) and dysphoric arousal (OR = 1.27, 95% CI [1.09, 1.49], p = 0.002) PTSD symptom clusters were associated with cannabis use reported in the same survey period. Results from the lagged models found no proximal associations between PTSD symptom clusters and cannabis use. CONCLUSIONS: Results highlight the acute effects of externalizing behavior and dysphoric arousal PTSD symptoms on cannabis use among women experiencing IPV. These findings may inform prevention and intervention efforts for cannabis use in this population.

Religiosity and hazardous substance use: The moderating role of trauma-related shame.

BACKGROUND AND OBJECTIVES: Hazardous substance use is a major public health concern among individuals with a history of sexual victimization. Although increased religiosity has been known to serve as a protective factor against hazardous substance use, religious individuals with a history of sexual victimization may be at a greater risk for hazardous substance use due to difficulties reconciling sexual victimization with their religious beliefs. Individuals with greater trauma-related shame may engage in hazardous substance use as a means of coping with the traumatic event. METHOD: The present study consisted of 614 participants (Mage = 34.57, 50% women). RESULTS: Results suggested that organizational, nonorganizational, and intrinsic religiosity were positively associated with hazardous alcohol use at higher, but not lower, levels of trauma-related shame. Organizational and intrinsic religiosity were positively associated with hazardous drug use at higher, but not lower, levels of trauma-related shame. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: This is the first study to examine the role of trauma-related shame in the relationship between religiosity and hazardous substance use. The findings underline the importance of targeting trauma-related shame in religious individuals with a history of sexual victimization.

Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro-longitudinal study.

BACKGROUND: Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level. METHODS: Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording. RESULTS: Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects. CONCLUSIONS: Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

Depression and alcohol use in American Indian adolescents: The influence of family factors.

BACKGROUND: Rates of both depression and alcohol use are disproportionately higher among American Indian (AI) adolescents than adolescents in the general population. The co-occurrence of depression and alcohol use is common and clinically relevant given their reciprocal negative influences on outcomes. Family factors may be especially relevant because they could have a buffering effect on this relationship due to the importance of kinship and community in AI communities. The current study examines the roles of family warmth and parental monitoring in the association between depressive symptoms and alcohol use in a large, nationally representative sample of AI adolescents. METHODS: Data were collected from 3498 AI 7th to 12th graders (47.8% female) residing on or near a reservation during the period 2009 to 2013. Participants reported on their depressive symptoms, family factors, and alcohol use. RESULTS: There was a small, but statistically significant positive association between depressive symptoms and alcohol use (r = 0.11, p < 0.001). Greater depressive symptoms were associated with significantly less perceived family warmth (ß = -0.09, 95% CI [-0.13, -0.06]), which was associated with significantly greater alcohol use (ß = -0.39, 95% CI [-0.55, -0.23]). Family warmth significantly accounted for the association between depressive symptoms and alcohol use at high (ß = 0.04, SE = 0.02, 95% CI [0.004, 0.09]), but not low, levels of parental monitoring (ß = 0.02, SE = 0.02, 95% CI [-0.002, 0.06]). CONCLUSIONS: Results of the present study suggest that developing culturally sensitive prevention and treatment approaches focusing on increasing both family warmth and parental monitoring are important to address the co-occurrence of depression and alcohol misuse among AI adolescents.

Exploring the moderating role of gender in the relation between emotional expressivity and posttraumatic stress disorder symptom severity among Black trauma-exposed college students at a historically Black university.

OBJECTIVES: Posttraumatic stress disorder (PTSD) is characterized in part by negative alterations of cognition or mood, including alterations in emotional expressivity, or the extent to which one outwardly displays emotions. Yet, research in this area has relied on predominantly white samples and neglected to consider the potential role of gender, despite there being demonstrated gender differences in both PTSD symptom severity and emotional expressivity, separately. The goal of the current study was to fill a critical gap in the literature by examining the moderating role of gender in the relation between PTSD symptom severity and emotional expressivity in a sample of trauma-exposed Black adults. METHODS: Participants were 207 Black individuals enrolled in a historically Black university in the Southern United States (68.6% female; Mage = 22.32 years). RESULTS: Findings provided support for the moderating role of gender in the association between PTSD symptom severity and emotional expressivity. Specifically, greater PTSD symptom severity was inversely related to emotional expressivity among trauma-exposed Black males and positively associated with emotional expressivity among trauma-exposed Black females. DISCUSSION: These results suggest the potential need for gender-specific assessment and treatment techniques for PTSD symptom severity among trauma-exposed Black college students.

Examining the Interaction Between Potentially Morally Injurious Events and Religiosity in Relation to Alcohol Misuse Among Military Veterans.

Given the disproportionate rate of alcohol misuse among veterans and related outcomes as compared to the general population, the examination of predictors of alcohol misuse in this population is imperative. Potentially morally injurious events (PMIEs), defined as severe transgressions of a moral code, have been positively associated with alcohol misuse. Exposure to PMIEs may challenge one's religious beliefs, which may, in turn, influence the strength of the association between PMIEs and alcohol misuse among military veterans. The goal of the current study was to examine the potential moderating role of religiosity in the association between PMIEs and alcohol misuse (i.e., alcohol consumption, drinking behaviors, adverse reactions to drinking, and alcohol-related problems). Participants were 496 military veterans in the community (Mage = 37.80 years, SD = 11.42; 70.5% male). The results of moderation analyses indicated that overall religiosity, organizational religiosity, and intrinsic religiosity significantly moderated the association between PMIEs and alcohol misuse such that the positive relation between PMIEs and alcohol misuse was stronger at high versus low levels of religiosity, R2 s = .01. Our findings highlight the importance of considering the role of religiosity in relation to alcohol misuse as a moral injury outcome and the potential utility of tailoring treatments for military veterans who have experienced moral injury.

Racial and ethnic differences in emotion regulation: A systematic review.

OBJECTIVE: Emotion regulation is a transdiagnostic mechanism with relevance to the etiology, maintenance, and treatment of a wide range of clinically relevant outcomes. This study applied systematic review methods to summarize the existing literature examining racial and ethnic differences in emotion regulation. METHODS: We systematically searched four electronic databases (PsycINFO, Embase, MEDLINE, and CINAHL Plus) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Of the initial 1253 articles, 25 met the inclusion criteria. Findings for emotion regulation strategies generally provide evidence for racial/ethnic differences (71% of reviewed studies), with ethnoracial minorities largely exhibiting greater use of emotion regulation strategies. Whereas the results for emotion regulation potential were slightly more mixed (63% of reviewed studies found racial/ethnic differences), ethnoracial minorities were also largely found to report lower emotion regulation potential. CONCLUSION: This review advances the literature by providing additional support for racial and ethnic differences in emotion regulation.

Posttraumatic Stress Disorder and Substance Misuse Among Black Emerging Adults: The Influence of Social Support.

Objective: Black emerging adults are significantly impacted by substance misuse. Posttraumatic stress disorder (PTSD) is associated with heightened substance misuse among Black emerging adults. However, limited research has identified protective factors that may influence the strength of the relation between PTSD and substance misuse in this population. Addressing this important limitation, the present study examined the potential moderating role of perceived social support in the association between PTSD symptoms and substance (i.e., alcohol and drug) misuse. Methods: Participants were 182 trauma-exposed Black emerging adults (M age = 20.50; 71.3% women) who completed self-report measures assessing PTSD symptoms, alcohol and drug misuse, and perceived social support. Results: PTSD symptoms were significantly and positively correlated with both alcohol and drug misuse. Moderation analyses indicated that positive relations between PTSD symptoms and both alcohol and drug misuse were only significant among Black emerging adults with lower (but not higher) levels of perceived social support. Conclusions: These findings suggest the potential utility of addressing social support in the assessment and treatment of substance misuse in trauma-exposed Black emerging adults.

Positive emotional intensity and substance use: the underlying role of positive emotional avoidance in a community sample of military veterans.

Background: Military veterans are at greater risk for substance misuse. Positive emotional intensity is one well-established antecedent of substance misuse in this population. Positive emotional avoidance, or attempts to alter the form, frequency, or context of positive emotions, may help to explain this association. While clinical practice typically aims to increase positive emotions, such approaches may have iatrogenic effects, as high-intensity positive emotions may be experienced as distressing and prompt avoidance for some populations. This suggests a need to better understand responses to positive emotions to inform clinical practice.Objectives: The goal of the current study was to advance theory, research, and clinical practice by exploring the role of positive emotional avoidance in the associations between positive emotional intensity and both alcohol and drug misuse. We hypothesized that positive emotional intensity would indirectly influence alcohol and drug misuse through positive emotional avoidance.Methods: Participants were a community sample of United States military veterans recruited through Amazon's Mechanical Turk (n = 535, Mage = 37.45, 71.8% male, 69.5% White).Results: Correlations among positive emotional intensity, positive emotional avoidance, and alcohol and drug misuse were significant and positive (rs range from.13 to.41). Further, positive emotional avoidance was found to account for the relations of positive emotional intensity to alcohol (indirect effect: b =.04, 95%CI [.01,.08]) and drug misuse (indirect effect: b =.01, 95%CI [.01,.02]).Conclusions: Results provide preliminary support for the potential clinical utility of targeting avoidance responses to positive emotions in interventions targeting alcohol and drug misuse among military veterans.

Ethnic-racial identity and posttraumatic stress disorder: The role of emotional avoidance among trauma-exposed community individuals.

OBJECTIVE: There are ethnic-racial differences in the prevalence of posttraumatic stress disorder (PTSD). However, the factors underlying these differences are not well studied or understood. The goal of this study was to explore the relation of strength of ethnic-racial identity to PTSD. Specifically, we examined whether strength of ethnic-racial identity was indirectly related to PTSD symptom severity through positive and negative emotional avoidance. METHOD: Participants were 401 trauma-exposed community individuals (Mage = 43.86 years; 70.1% female; 23.4% Asian, 23.7% Black, 25.1% Hispanic, 25.4% White). RESULTS: Within the overall sample of ethnic-racial minorities, the indirect effect of strength of ethnic-racial identity on PTSD symptom severity through the pathways of both positive and negative emotional avoidance was significant. However, these findings were not replicated within each of the specific racial-ethnic subsamples. Specifically, while strength of ethnic-racial identity was indirectly associated with PTSD symptom severity through both positive and negative emotional avoidance in the Black subsample, this indirect effect was only significant through the pathway of positive emotional avoidance in the Hispanic subsample, and was nonsignificant in the Asian and White subsamples. CONCLUSIONS: Results underscore ethnic-racial differences in the way in which strength of ethnic-racial identity impacts PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The moderating role of emotion dysregulation in the relation between potentially morally injurious experiences and alcohol misuse among military Veterans.

Alcohol misuse is a serious and pervasive problem among US military Veterans. The commission or omission of acts that transgress important moral standards, known as potentially morally injurious events (PMIEs), has been theoretically and empirically linked to alcohol misuse in this population. Emotion dysregulation has been implicated in the pathogenesis of alcohol misuse and may be relevant in the context of PMIEs. The goal of this study was to examine the roles of negative and positive emotion dysregulation in the relation between PMIEs and alcohol misuse. Participants were a community sample of US military Veterans who were predominantly white (69.5%) and male (71.6%), with a mean age of 38.00. The interaction between PMIEs and both negative and positive emotion dysregulation (separately) significantly predicted alcohol misuse. Simple slopes tests revealed that the relation between PMIEs and alcohol misuse was only significant at high levels of negative and positive emotion dysregulation. Findings underscore the potential utility of targeting both negative and positive emotion dysregulation in alcohol misuse interventions for military Veterans experiencing PMIEs.

Difficulties Regulating Positive Emotions and Substance Misuse: The Influence of Sociodemographic Factors.

Background: Alcohol and drug misuse present significant public health concerns due to their high prevalence and deleterious outcomes. A growing body of research provides support for the role of difficulties regulating positive emotions in alcohol and drug misuse. However, research is needed to better understand for whom difficulties regulating positive emotions are most strongly associated with alcohol and drug misuse to inform assessment and treatment efforts. Objectives: The goal of the present study was to examine potential sociodemographic moderators (i.e. age, gender, ethnicity, race, income, and educational attainment) in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Methods: Participants were 373 trauma-exposed adults (57.1% female, 75.8% White) recruited from the community. Results: Significant differences were identified across sociodemographic groups regarding difficulties regulating positive emotions (i.e. gender, ethnicity, race, and income) and alcohol use (i.e. gender). Moderation analyses revealed a significant interaction between difficulties regulating positive emotions and gender on drug misuse (b = 0.08, p < .001), such that the association was significant for females (b = 0.11, p < .001) but not males (b = .03, p = .05). Conclusions: Results suggest the importance of developing gender-sensitive recommendations for the assessment and treatment of substance misuse, and of incorporating techniques focused on addressing difficulties regulating positive emotions.