Some thoughts on: Psychology of Addictive Behaviors v34, N0. 4

Below are some thoughts that came to me as a read through this current journal.  I tend to first reflect on how the results of research relate to basic psychological principles and secondarily what it means to my main interests and treatment work.  

The relationship between unplanned drinking and event-level alcohol-related outcomes.
Pages 497-505. Lauher, Miranda L.; Merrill, Jennifer E.; Boyle, Holly K.; Carey, Kate B. https://doi.org/10.1037/adb0000553

This article appears to reflect the role that expectations play in drinking outcomes.  Specifically planned drinking events more clearly define psychosocial context and will likely have more concrete expectations than non-planned events and thus prompt higher consumption.  This raises the question of the role that expectations play in planned abstinence and adherence to the abstinence plan.  This likely has both biological and psychological components for example: cells can produce a lasting response to a memory or trigger and this can be reinforced by social influence and impulse in context.        

Bidirectional relationship of posttraumatic stress disorder (PTSD) symptom severity and alcohol use over the course of integrated treatment.
Pages 506-511. Tripp, Jessica C.; Worley, Matthew J.; Straus, Elizabeth; Angkaw, Abigail C.; Trim, Ryan S.; Norman, Sonya B. https://doi.org/10.1037/adb0000564

It is not a surprising outcome that alcohol use increased with severity of PTSD symptoms. All attempts to mask traumatic experiences ultimately fail as the experiences, as troubling as they may be, are real and important parts of an individual’s history.  Exposure and cognitive therapies work toward integrating these experiences in a way that an individual can apply meaning and have the ability to move forward in life.  Alcohol use as a way to “deal” interferes with this process.  As with most co-occurring disorders, substance use and other symptoms interact in reinforcing ways making sequential treatment mostly ineffective.   

Relations among religiosity, age of self-identification as gay, lesbian, or bisexual, and alcohol use among college students.
Pages 512-520. Corbin, William R.; Ong, Thai Q.; Champion, Charlie; Fromme, Kim. https://doi.org/10.1037/adb0000559

Struggles to reconcile sexual identity and other elements of identity in a non-hospitable context likely result in adverse childhood experiences (ACES) that predict adverse outcomes including substance use difficulties.  The author suggests some strategies that would result in an integration and reformulation of these experiences that include altering, or integrating into a more hospitable context that is supportive of a completed identity formulation.  As family and the self help community it is important that people are guided to places where they can receive psychosocial support outside of therapy as part of their plan.      

The new normal: Changes in drinking norms from college to postcollege life.
Pages 521-531. Hamilton, Hannah R.; Armeli, Stephen; Litt, Mark; Tennen, Howard. https://doi.org/10.1037/adb0000562

I think that this really reflects the research showing how the context and psychosocial factors influence perceptions, expectations and behavior. This is in line with Stanton Peele’s extensive work on how social forces influence substance use problems; in other words, the opioid epidemic is at least in part a societal issue that treatment cannot fix.  Multiple treatments and relapses are in part a function of one’s inability to extract themselves from a context and psychosocial influences that drive behaviors outside of consciousness. The AA self help tradition highlights this in their references to “people, places and things.”

 

A web-based episodic specificity and future thinking session modulates delay discounting in cannabis users.
Pages 532-540. Sofis, Michael J.; Lemley, Shea M.; Lee, Dustin C.; Budney, Alan J. https://doi.org/10.1037/adb0000557

Delayed discounting, the tendency to value more immediate rewards over later, seemingly more significant rewards, has static trait qualities in that tendencies are heritable.  While this is the case, there is research, including this article, that suggest that the trait is malleable and a  person’s discounting may differ dependent upon what they are waiting for, or in the context of other influences.  It may be a consideration of importance in treatment where the immediate reward of drug use takes precedence over delayed consequences.  This idea is the basis for contingency management strategies that have proven to be successful for some.  For others interim rewards that can be viewed as leading back to a larger reward may better serve the purpose.  Scaling interest and confidence levels on short and long term rewards may help frame these dynamics and set the stage for appropriate interventions. 

 

Appearance-related teasing and substance use during early adolescence.
Pages 541-548. Klinck, Melanie; Vannucci, Anna; Fagle, Tessa; Ohannessian, Christine McCauley. https://doi.org/10.1037/adb0000563

Not surprising that this form of bullying results in attempts to cope which include increased alcohol use; interesting that it did not result in changes in marijuana use.  The question that was not answered was what mitigation strategies might be helpful beyond those of prevention and education strategies; research on the effectiveness of these programs has been mixed.  The larger problem with an individual case  is the concurrent task of identity formation that adolescence involves.  Therapy that helps to tease out the “who I am” can serve to refocus attention on strengths that can be built upon.

Problematic social media use is associated with increased risk-aversion after negative outcomes in the Balloon Analogue Risk Task.
Pages 549-555. Meshi, Dar; Ulusoy, Ezgi; Özdem-Mertens, Ceylan; Grady, Sara M.; Freestone, David M.; Eden, Allison; Ellithorpe, Morgan E. https://doi.org/10.1037/adb0000558

Not sure how to parse this out as it does not appear that the risk challenge was related to the problematic use analysis directly.  One thought is that, given that the challenge was introduced after the SNS problematic use assessment and that the social reinforcers that lead to problematic SNS use carried into the risk challenge.  In other words, negative feedback in a social network may lead to moderating responses (risk) in an effort to curry favor in future interactions, or maintain a perceived desired image.  Moderating risk in less risky circumstances may serve the same purpose when carried over into the risk decision making in the BART task.