Excessive Substance Use Research Articles

Substance-induced and independent major depressive disorder in treatment-seeking alcoholics: associations with dysfunctional attitudes and coping.

This study examines the validity of the distinction between substance-induced and independent major depressive disorder (MDD) among alcoholics utilizing variables theoretically linked to the etiology and course of depression: specifically dimensions of coping and dysfunctional attitudes about the self that can lead to extreme negative interpretations of life events. Participants were 166 alcohol-dependent patients with elevated depressive symptoms. Comparisons were made between participants who met criteria for a current substance-induced major depressive episode and did not have a history of independent MDD (SIDD) and those who met criteria for a current major depressive episode and had either a past or current episode of independent MDD (IMDD). We also compared both of these groups to participants who have never met criteria for a depressive episode (NMDE). Depressive symptoms were correlated negatively with dimensions of adaptive coping and positively with maladaptive coping and dysfunctional attitudes. Women were overrepresented in the IMDD group, but the diagnostic groups did not differ significantly in other demographic characteristics or in measures of substance use. Participants with IMDD reported greater dysfunctional attitudes than those with NMDE and those with SIDD, who did not differ from each other. Frequency of antidepressive coping behaviors was lowest among those with IMDD, was significantly higher in those with SIDD and was highest among those with NMDE. Results suggest depressed alcoholics who have experienced episodes of depression independent of excessive substance use possess cognitive vulnerabilities and coping deficits that may render them prone to depression.

Analysis of risk taking in adults with a history of high risk behavior

Antisocial behavior often involves frequent risk-taking, e.g. excessive substance use and criminality, which may lead to destructive consequences. In the present study, adults with a history of high-risk behavior (primarily drug dependence and conduct disorder) and matched controls worked on a novel laboratory task designed to measure risk-taking. The contingencies of the task were such that choosing a ‘risky’ response option resulted in a net loss of monetary earnings compared to a safer, more conservative response alternative. The risky option offered a low probability of a large monetary reward or a high probability of a smaller monetary loss. The non-risky option protected current earnings. High-risk history subjects chose the risky option more often, had lower overall earnings, and were more likely to persist in making (losing) risky responses following a single gain on the risky option. The data support theories of maladaptive behavior focused on hypersensitivity to reward and insensitivity to aversive events.

Substance Use Restraint: An Extension of the Construct to a Clinical Population

Restraint is a construct of potential use forunderstanding addictive behaviors. In terms of alcoholand other drug use, restrained individuals arecognitively and behaviorally preoccupied withcontrolling their substance use. Previous work in thecontext of alcohol consumption suggests that whenregulation fails, alcohol and other drug users are morelikely to engage in excessive substance use. Thisproposition was evaluated in a clinical population ofalcohol and other substance users admitted to aninpatient treatment program. A confirmatory factoranalysis of alcoholics' responses to the Temptation andRestraint Inventory, a measure of drinking restraint,replicated the two second-order factors previouslyreported for social drinkers: Cognitive and EmotionalPreoccupation (CEP) and Cognitive and Behavioral Control (CBC). CEP scores were a negative predictor ofpretreatment percentage of days abstinent and a positivepredictor of percentage of drinking days engaged inheavy drinking, drinks per drinking day, and drinking consequences. CBC scores were a negativepredictor onlyof drinks per drinking day. An analysis ofdrug users' responses to a drug version of theTemptation and Restraint Inventory also replicated thepreviously found CEP and CBC factors. Scores on the CEPfactor were a positive predictor and scores on the CBCfactor a negative predictor of drug use frequency. CEPscores also were a positive predictor of drug use consequences. The data taken together representa potentially useful extension of the restraintconstruct to alcoholics and other drug users and supporta multifactorial characterization of substance use restraint as reflecting a reciprocalrelationship between restricted and excessive substanceuse.

The environmental intergenerational transmission of alcohol problems: A comparison of two hypotheses

Two competing hypotheses concerning the mechanism of transmission of excessive substance use from one generation to the next are tested, using data from a study of 16- to 35-year-old offspring of problem-drinking parents. The 'positive influence' hypothesis predicts that the more positive has been the offspring's relationship with the problem-drinking parent during upbringing, the greater the risk of excessive drinking or drug taking in young adulthood. This hypothesis received support only for women with fathers with drinking problems. The 'relationship deficiency' hypothesis predicts that those offspring most at risk are those who have had the more negative relationships with parents. This hypothesis received some support in the case of men with mothers with drinking problems: this subgroup of offspring were more at risk if they reported having had poor relationships with their fathers. It is concluded that the environmental intergenerational transmission of problems of excessive substance use occurs via a variety of mechanisms which are likely to be of differential importance in different subgroups.

Is excessive gambling seen as a form of dependence? Evidence from the community and the clinic

Data from two studies are used to examine the proposition that excessive gambling, unlike excessive substance use, is not generally viewed as a form of dependence. In the first study, the attitudes of 100 members of the general population towards the causes of excess and towards appropriate treatments, indicated that excessive gambling was seen in more moral terms than were other addictive behaviours. In the second study, of 54 people receiving treatment for one of four forms of excessive behaviour, gamblers were just as likely to use terms such as 'addiction' or 'compulsion' to describe their behaviour but were also more likely than others to describe it in terms of moral weakness or vice. Concern is expressed at the way in which gambling may be marginalized as a form of dependence.