Self-medication Theory Research Articles

Substance abuse among mothers in Taiwan: Investigating its prevalence and testing the trauma model

Substance abuse is a serious problem in our society. In particular, household or parental substance abuse could lead to adverse childhood experiences for the affected children. However, little is known about the prevalence of substance abuse among parents, especially in Asian societies. Moreover, although the trauma model of addiction has significant implications for the prevention and treatment of substance abuse, most evidence comes from Western samples. To address these knowledge gaps, we examined the prevalence of substance abuse in a sample of mothers in Taiwan and tested the trauma model of substance abuse. A total of 867 Taiwanese mothers completed standardized self-report assessments in 2023. The screening results indicated that the 12-month prevalence of drug abuse and alcohol abuse was 12.3% and 7.3%, respectively; 15.5% had either or both drug and alcohol abuse. Most types of trauma exposure were associated with drug abuse severity, while interpersonal stress and dissociative symptoms were associated with alcohol abuse severity, even after controlling for a variety of demographic and health variables as well as general psychopathology (i.e., depressive symptoms). The relatively high prevalence of substance abuse among Taiwanese mothers in our sample is concerning, particularly when compared to the rates reported in other Asian samples. We also provide preliminary cross-cultural evidence supporting the self-medication theory and the trauma model of substance abuse in the Asian context. We discuss the potential importance of addressing trauma and stress to prevent substance abuse and call for follow-up studies.

Psychoactive Substance Abuse among Secondary School Students in Tanzania: Exploring Perception and Understanding of Its Impact on Academic Achievement

The aim of this study was to explore perceptions and understanding of the impact of drug and psychoactive substance abuse among Secondary School students Kilolo district of Iringa Tanzania. The study was guided by the following specific objectives: to identify the commonly used psychoactive drug and substances; to explore students’ perceptions on psychoactive substance use; to examine students’ knowledge of the impact of psychoactive substance abuse on academic achievement; and to explore the strategies used in preventing use of drugs and substance abuse at Secondary School level. The study was guided by the Self-Medication Theory of Addiction. The theory that provides a valuable investigative and clinical paradigm to address the challenging issue of drug addiction. The study used a quantitative approach with a cross-section descriptive design. Employing simple random sampling, a total sample of 400 respondents were drawn from five secondary schools of Kilolo district. The data were obtained through questionnaire-based survey. The data were analysed using descriptive statistics with the aid of IBM SPSS Statistics version 20. The findings revealed that the commonly used psychoactive substances by secondary school students were alcohol, marijuana, snuff, and cigarettes. The students had the knowledge of drugs and substance abuse and perceive that they are not good for their academics and health. The study further unveiled that some students used the substances sparingly and while others used them on a daily basis. The findings showed that students had knowledge of the impact of psychoactive substance abuse on academic achievement. The findings also revealed that mechanism are in place at the school level to prevent drugs and psychoactive substance abuse. In view of the findings of this study it is recommended that families should be involved in the fight against use of drugs and psychoactive substances and provide counsel for the students. Schools should strive at encouraging positive peer relationships and networks among students who do not use psychoactive substances.

Perceived stigma, substance use and self-medication in night-shift healthcare workers: a qualitative study

BackgroundMany risk factors related to altered circadian rhythms impact the health of night-shift hospital workers (NSHW), resulting in mental and somatic disorders. Easy access to psychoactive substances (PS) may facilitate addictive behaviors in NSHW. They are also exposed to a stressful work environment, which may further affect sleep quality. This study aimed to explore the link between sleep deprivation, work-related psychosocial stress and psychoactive substance use as a self-medication response in NSHW.MethodsQualitative study to verify the plausibility of the self-medication theory applied to addictive behaviors. Semi-structured interviews (N = 18 NSHW) and thematic analysis, following consolidated criteria for reporting qualitative research recommendations.ResultsStigma against NSHW was a primary element of a stressful work environment. The stressful and stigmatizing environment, together with night-shift work, further affected NSHW sleep and their mental and physical health. The use of PS appeared to be for self-medication, encouraged by social and professional environments, source(s) of stress, discrimination, and isolation. The work environment, through aggravated sleep disorders, led NSHW to use non-prescribed sleeping pills. Alcohol after work and smoking were used as a social break but also as a means to reduce stress. ConclusionAnti-stigma interventions in the healthcare setting and screening of mental/somatic disorders in NSHW can help reduce harmful self-medication behaviors and improve hospital care in the COVID-19 era.

Examination of Sex-Related Distress and Self-Medication Drinking Model in U.S. College Women

ABSTRACT Adult sexual assault (ASA) in college remains a concern. Consequently, many college-aged women experience negative emotions surrounding sexual activity (sex-related distress). Consistent with self-medication theory, some drink to cope with sex-related distress, which may reduce distress, but lead to greater drinking quantity before sex and negative sexual consequences. How women with ASA histories navigate sexual situations and cope with sex-related distress is under researched. We examined ASA, sex-related distress, and drinking to cope motives to understand correlates of drinking before sex. First and second year college women (n = 300) reported on a recent sexual experience in the past six weeks. In the full sample, ASA severity was associated with a greater likelihood of drinking before sex, while general sex-related distress was associated with a lower likelihood. General sex-related distress was associated with event-specific sex-related distress and sexual consequences. There were no differences in number of pre-sex drinks or subjective intoxication during sexual activity based on ASA. In a subsample of women who drank before sexual activity (n = 179), drinking to cope with sex-related distress motives mediated the association between sex-related distress and sexual consequences. Interventions can draw on these findings to target self-medication drinking in consensual sexual situations.

Age Effect on the Bidirectional Relations Between Alcohol Consumption and Pain

Alcohol consumption reduces but pain rises over the life course. Thus, we hypothesized that developmental variability in the bidirectional association between alcohol consumption and pain would vary as a function of age. This hypothesis was tested across three age groups – younger (<29), middle (29-65), and older (>65) using NESARC wave 1 and 2 data (N=34,653). The effect of pain interference at baseline on alcohol consumption at follow-up was non-significant across the age groups, indicating that self-medication theory was unsupported. The effect of alcohol consumption at baseline on pain interference at follow-up was significant among the middle (Estimate -.007, p=.002) and older (Estimate -.019, p<.001) groups, but non-significant among the younger group. This latter effect differed significantly between the younger and older groups (p =.005) and the middle and older groups (p=.041). Results show that alcohol consumption reduces pain interference, especially later in life.

Risk factors for elevations in substance use and consequences during the COVID-19 pandemic among sexual and gender minorities assigned female at birth

BackgroundProblematic substance use (SU) has increased substantially during the COVID-19 pandemic. While studies have identified risk factors for problematic SU during the pandemic (e.g., anxiety, depression, using substances to cope), these studies have been predominately cross-sectional, rarely examined changes in SU contexts during the pandemic as potential risk factors, and neglected sexual and gender minorities (SGM) – a health disparity population disproportionately impacted by substance use disorders and the pandemic. MethodWe utilized two waves of data collected one month apart from a sample of 212 SGM assigned female at birth who used alcohol and/or cannabis (18–25 years old) collected between August 2020-February 2021. We examined associations between potential risk factors (i.e., retrospectively reported changes in anxiety/depression and in using substances in different contexts since before the pandemic): and 1) retrospectively reported changes in alcohol and cannabis consumption; 2) coping motives for use and SU consequences; and 3) subsequent changes in coping motives and consequences. ResultsAn increase in solitary SU was a robust risk factor for concurrent and prospective increases in SU, coping motives, and consequences. Increases in SU with romantic partners were associated with concurrent increases in alcohol/cannabis consumption and consequences. Increases in anxiety and depression were associated with concurrent increases in SU and higher coping motives and consequences. ConclusionsResults indicate that solitary SU and increases in SU with romantic partners are robust risk factors for increases in SU and consequences in the context of the pandemic. Further, findings provide support for the self-medication theory of substance use.

Pharmacological approaches of ADHD

Abstract BodyAdults with ADHD describe self-medicating with cannabis. A small number of psychiatrists in the US prescribe cannabis medication for ADHD, despite there being no evidence from trials. The EMA-C trial (Experimental Medicine in ADHD-Cannabinoids) was a pilot randomised placebo-controlled experimental study of a cannabinoid medication, Sativex Oromucosal Spray, in 30 adults with ADHD. The primary outcome was cognitive performance and activity level using the QbTest. Secondary outcomes included ADHD and emotional lability (EL) symptoms. From 17.07.14-18.06.15, 30 participants were randomly assigned to the active (n=15) or placebo (n=15) group. For the primary outcome, no significant difference was found in the intent-to-treat analysis although the overall pattern of scores was such that the active group usually had scores that were better than the placebo group (Est=-0.17,95%CI-0.40-0.07, p=0.16, n=15/11 active/placebo). For secondary outcomes Sativex was associated with a nominally significant improvement in hyperactivity/impulsivity (p=0.03) and a cognitive measure of inhibition (p=0.05), and a trend towards improvement for inattention (p=0.10) and EL (p=0.11). Per-protocol effects were higher. Results did not meet significance following adjustment for multiple testing. One serious (muscular seizures/spasms) and three mild adverse events occurred in the active group and one serious (cardiovascular problems) adverse event in the placebo group. Adults with ADHD may represent a subgroup of individuals who experience a reduction of symptoms and no cognitive impairments following cannabinoid use. While not definitive, this study provides preliminary evidence supporting the self-medication theory of cannabis use in ADHD and the need for further studies of the endocannabinoid system in ADHD.DisclosureDuring this work-RC was a Ph.D. student funded by a grant to PA from Vifor Pharma. PA received funds (consultancy/sponsored talks/research/education) from Shire, Lilly, Novartis, Janssen, PCMScientific, Vifor Pharma, QBTech. Sativex was free from GW Pharm

Cannabis and Its Different Strains.

Previous studies show how time perception can be altered by cannabis consumption, but it is not clear yet whether cannabis produces temporal underproductions or overproductions after acute cannabis intoxication. The present study aimed to analyze a sample of 50 regular cannabis users controlling for cannabis strain (sativa, indica, and hybrid) and to compare their scores in a temporal production task before and after consuming cannabis with a control group of 49 nonusers. Results showed that cannabis intake leads to overproductions, suggesting that regular users' internal tempo slows down after acute intoxication. However, the analyses of main effects showed that indica users, both at baseline levels and after consuming, reported significant underproductions compared to controls, sativa, and hybrid users, and the cannabis-induced effects had a higher magnitude after smoking in the indica-strain group. Results highlight the relevance of including the type of strain consumed in cannabis studies, and they are discussed in terms of short- and long-term alterations in temporal perception under the light of the self-medication theory and the therapeutic uses of cannabis.

Addictive behaviors across the menstrual cycle: a systematic review.

Research examining relations between menstrual cycle phase and female addictive behaviors is accumulating. Theories suggest addictive behaviors may increase during specific phases of the menstrual cycle resulting from cyclical fluctuations in hormones and affect. In line with self-medication theory, we predicted that addictive behaviors would increase premenstrually and menstrually, phases marked by elevations in negative affect, relative to the follicular and luteal phases. We also hypothesized, coinciding with reward-sensitivity theory, that addictive behaviors may increase during ovulation, a phase characterized by increased positive affect, compared to the same phases. This systematic review summarizes extant literature examining the menstrual cycle phase-addictive behavior relationship and underlying motivations. Articles pertaining to menstrual cycle phase and addictive behaviors within the PsycINFO, CINAL, and PubMED databases were screened to determine eligibility following PRISMA guidelines (n = 1568). Thirty-four articles examining alcohol use, cannabis use, nicotine use, caffeine use, and gambling behavior across menstrual cycle phase met inclusion criteria. Consistent with self-medication theory, strong evidence indicated that nicotine use increased premenstrually and menstrually. Other factors increasing both nicotine and alcohol use premenstrually and menstrually include having a premenstrual dysphoric disorder diagnosis or having premenstrual syndrome. Motivations for using alcohol and nicotine may too vary by menstrual cycle phase. Results were less consistent or understudied for other addictive behaviors and thus conclusions cannot be drawn. Menstrual cycle phase appears to be a female-specific factor affecting some addictive behaviors, particularly nicotine use, and should be considered when conducting addictive behavior research or clinical interventions for reproductive-aged females with addictive disorders.

Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic.

Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic.Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing (“pre-social-distancing”), and the 30 days after the start of state-mandated social distancing (“post-social-distancing”).Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking.Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students

Background College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. Purpose: This study evaluated the mediating role of coping styles (i.e. problem-solving and avoidance coping) on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences [ARNC]). Methods: A national sample of 672 traditional age (i.e. 18–25 years old; M = 22.35, SD = 1.97) college students who reported alcohol consumption in the past month were recruited via Amazon’s Mechanical Turk website. Participants were 55.1% male and 60.9% White and completed measures of PTSD symptoms, coping styles, hazardous drinking, and ARNC. Results: Problem-solving coping mediated the positive relationship between PTSD symptoms and hazardous drinking such that PTSD symptoms were negatively associated with problem-solving coping, which was negatively associated with hazardous drinking. Avoidance coping mediated the positive relationship between PTSD symptoms and ARNC through a positive association between PTSD symptoms and avoidance coping. Conclusions: These novel findings highlight the importance of adaptive coping styles as a protective factor for college students experiencing co-occurring PTSD symptoms and harmful alcohol use.

Ashamed and Alone-Risk Factors for Alcohol Craving Among Depressed Emerging Adults.

Comorbid alcohol use and depression have the highest prevalence among emerging adults and are associated with a number of consequences. Self-medication theory posits individuals with depression use alcohol to cope with their negative emotions. Preliminary work has investigated the social context of depression-related drinking and found that solitary drinking is a risky, atypical behaviour in emerging adulthood that is associated with alcohol misuse. However, it is unknown about what is unfolding in the moment that is driving depression-related drinking in solitary contexts. Accordingly, we used an experimental study to examine if shame mediated the association between depression and in-lab alcohol craving. Emerging adults (N=80) completed a shame induction followed by an alcohol cue exposure in either a solitary or social condition. We used moderated mediation to test hypotheses. Consistent with hypotheses, conditional indirect effects supported the mediation of depression and alcohol craving through shame among those in the solitary condition, but not in the social condition. There was no support for guilt as a mediator. Our study demonstrates that shame is a specific emotional experience that contributes to solitary drinking among depressed emerging adults. It is important to use these results to inform interventions that directly target solitary contexts and shame.

Examining Subgroups of Depression and Alcohol Misuse in Emerging Adults During University: a Replication and Extension Study

Alcohol misuse and depression are highly comorbid. Self-medication theory posits that depressed individuals use alcohol to reduce negative emotions. Research suggests that the co-pattern of depression and alcohol misuse is not uniform, and that emerging adults transitioning out of university can be differentiated into subgroups based on their co-patterns. We aimed to replicate and extend this study with emerging adults during university by examining whether baseline individual differences predicted subgroup membership. Undergraduates (N = 300) completed four waves of self-reports at 6-month intervals over 18-months. Parallel process latent class growth modeling supported three classes: Class 1, the “high-risk comorbid” group, had high stable depression and high stable alcohol misuse (n = 28). Class 2, the “moderate-risk depression-only group” had high stable depression but low decreasing alcohol misuse (n = 87). Class 3, the “low-risk normative” group, had low stable depression and low decreasing alcohol misuse (n = 185). Multinomial regressions showed that male sex, higher hopelessness, impulsivity, and anxiety sensitivity, and higher coping-with-depression and enhancement drinking motives, differentiated Class 1 from Class 3. Higher impulsivity and lower hopelessness, and higher enhancement motives, differentiated Class 1 from Class 2. Higher hopelessness, and higher coping-with-depression and conformity motives, differentiated Class 2 from Class 3. We utilized a subclinical sample and a short follow-up period. Emerging adults display differing co-patterns of depression and alcohol misuse over time during university, including both high-, moderate-, and low-risk subgroups. Our results provide novel evidence subgroups that can be distinguished based on sex, drinking motives, and personality.

A Pilot Daily Diary Study of Changes in Stress and Cannabis Use Quantity Across the Menstrual Cycle

Menstrual cycle (MC) phase appears to influence changes in females’ addictive behaviours (e.g., drinking,cigarette smoking). Few studies have examined cannabis use across the MC. We examined phase-specific changes in stress and cannabis use quantity across the MC in daily cannabis users. We hypothesized there would be an increase in self-reported stress and cannabis quantity premenstrually and menstrually versus other MC phases. Data were obtained prospectively, using a 32-day daily diary, from 14 normally- cycling, community-recruited, female cannabis users (Age: M = 29.3 years old, SD = 4.9). Participants completed measures pertaining to their daily stress levels (the General Stress Scale) and the quantity of cannabis used daily. A priori planned comparison t-tests and non-parametric Wilcoxon rank tests revealed MC phase effects on stress levels and cannabis quantity, respectively. In partial support of stress-response dampening (SRD) model and self-medication theory (SMT) predictions, stress levels were higher in the premenstrual versus the ovulatory phase, and a higher quantity of cannabis was used premenstrually versus the follicular and ovulatory phases. Findings suggest stress levels and cannabis use quantity are MC phase-sensitive. Results are consistent with SRD model and SMT predictions, where females learn to increase the quantity of cannabis used premenstrually to dampen their heightened stress response and negative affect. Female cannabis users of reproductive age could be trained to employ alternative strategies to cope with elevated stress during the premenstrual phase to prevent increased cannabis use.

Retrospective and prospective assessments of gambling-related behaviors across the female menstrual cycle.

Background and aimsDespite increases in female gambling, little research investigates female-specific factors affecting gambling behavior (GB). Although research suggests that some addictive behaviors may fluctuate across menstrual cycle phase (MCP), gambling requires further investigation. In two studies, we examined associations between MCP and three risky GBs: time spent gambling, money spent gambling, and the probability of consuming alcohol while gambling. Associations between MCP and negative affect were also examined in Study 2. We predicted that, consistent with self-medication theory, increases in negative affect (Study 2) and risky GBs (Studies 1 and 2) would occur premenstrually/menstrually relative to other phases.MethodsData were obtained from 33 female gamblers using a retrospective timeline followback procedure (Study 1) and from 20 female gamblers using a prospective 32-day, daily diary method (Study 2). In Study 2, salivary progesterone levels verified self-reported MCP validity.ResultsFindings revealed significant, but somewhat inconsistent, MCP effects on GBs across studies. The self-medication hypothesis was partially supported. Increases relative to another MCP(s) were found for alcohol consumption while gambling premenstrually, time spent gambling menstrually/premenstrually, money spent gambling menstrually, and negative affect premenstrually. Unexpectedly, findings more consistently indicated that GBs increased during ovulation, suggestive of enhanced reward sensitivity. Progesterone assays validated self-reported MCP (Study 2).Discussion and conclusionsThe results suggest a role of ovarian hormones on negative affect and GBs in females. This research could lead to the identification of female-specific factors affecting gambling and the development of more effective interventions for females with, or at risk for, problematic gambling.

Preservation Effect: Cigarette Smoking Acts on the Dynamic of Influences Among Unifying Neuropsychiatric Triple Networks in Schizophrenia.

The high prevalence of cigarette smoking in schizophrenia (SZ) is generally explained by the self-medication theory. However, its neurobiological mechanism remains unclear. The impaired dynamic of influences among unifying neuropsychiatric triple networks in SZ, including the central executive network (CEN), the default mode network (DMN), and the salience network (SN), might explain the nature of their syndromes, whereas smoking could regulate the dynamics within networks. Therefore, this study examined whether cigarette smoking could elicit a distinct improvement in the dynamics of triple networks in SZ and associated with the alleviation of symptoms. Four groups were recruited, namely, SZ smoking (n = 22)/nonsmoking (n = 25), and healthy controls smoking (n = 22)/nonsmoking (n = 21). All participants underwent a resting-state functional magnetic resonance imaging (fMRI). The dynamics among unifying neuropsychiatric triple networks were measured using Granger causality analysis on the resting-sate fMRI signal. Interaction effects between SZ and smoking on dynamics were detected using 2-way analysis of covariance, correcting for sex, age, and education level. Whereas smoking reduced SN→DMN dynamic in healthy controls, it preserved the dynamic in SZ, thus suggesting a preservation effect. Moreover, smoking additionally increased DMN→CEN dynamic in SZ. This finding from neural pathways shed new insights into the prevailing self-medication hypothesis in SZ. More broadly, this study elaborates on the neurobiological dynamics that may assist in the treatment of the symptomatology of SZ.

The Indirect Effect of Posttraumatic Stress Disorder Symptoms on Current Alcohol Use Through Negative Cognitions in Sexual Minority Men.

Self-medication theory posits that some trauma survivors use alcohol to cope with posttraumatic stress disorder (PTSD) symptoms, but the role of negative posttraumatic cognitions in this relationship is not well defined. We examined associations among PTSD symptoms, posttraumatic cognitions, and alcohol intoxication frequency in 290 men who have sex with men (MSM), who reported a history of childhood sexual abuse (CSA). Using a bootstrap approach, we examined the indirect effects of PTSD symptoms on alcohol intoxication frequency through posttraumatic cognitions regarding the self, world, and self-blame. In separate regression models, higher levels of PTSD symptoms and posttraumatic cognitions were each associated with more frequent intoxication, accounting for 2.6% and 5.2% of the variance above demographics, respectively. When examined simultaneously, posttraumatic cognitions remained significantly correlated with intoxication frequency whereas PTSD symptoms did not. Men reporting elevated posttraumatic cognitions faced increased odds for current alcohol dependence, odds ratio (OR)=2.19, 95% CI [1.13, 4.22], compared with men reporting low posttraumatic cognitions, independent of current PTSD diagnosis. A higher level of PTSD symptom severity was indirectly associated with more frequent alcohol intoxication through cognitions about the self and world; the indirect to total effect ratios were 0.74 and 0.35, respectively. Negative posttraumatic cognitions pertaining to individuals' self-perceptions and appraisals of the world as dangerous may play a role in self-medication with alcohol among MSM with a history of CSA. Interventions targeting these cognitions may offer potential for reducing alcohol misuse in this population, with possible broader implications for HIV-infection risk.

Examining co-patterns of depression and alcohol misuse in emerging adults following university graduation

Depression and alcohol use disorders are highly comorbid. Typically, alcohol use peaks in emerging adulthood (e.g., during university), and many people also develop depression at this time. Self-medication theory predicts that depressed emerging adults drink to reduce negative emotions. While research shows that depression predicts alcohol use and related problems in undergraduates, far less is known about the continuity of this association after university. Most emerging adults “mature out” of heavy drinking; however, some do not and go on to develop an alcohol use disorder. Depressed emerging adults may continue to drink heavily to cope with the stressful (e.g., remaining unemployed) transition out of university. Accordingly, using parallel process latent class growth modelling, we aimed to distinguish high- from low-risk groups of individuals based on joint patterns of depression and alcohol misuse following university graduation. Participants (N = 123) completed self-reports at three-month intervals for the year post-graduation. Results supported four classes: class 1: low stable depression and low decreasing alcohol misuse (n = 52), class 2: moderate stable depression and moderate stable alcohol misuse (n = 35), class 3: high stable depression and low stable alcohol misuse (n = 29), and class 4: high stable depression and high stable alcohol misuse (n = 8). Our findings show that the co-development of depression and alcohol misuse after university is not uniform. Most emerging adults in our sample continued to struggle with significant depressive symptoms after university, though only two classes continued to drink at moderate (class 2) and high (class 4) risk levels.

Why are Antidepressant Drugs Effective Smoking Cessation Aids?

BackgroundBefore the advent of varenicline, antidepressant drugs were reported to exhibit better clinical efficacy than nicotine replacement therapy as smoking cessation aids. The most studied is bupropion, a clinically-effective antidepressant, the first to be marketed throughout Europe for smoking cessation. Since depression and tobacco smoking have a high incidence of co-occurrence, this would implicate an underlying link between these two conditions. If this correlation can be confirmed, then by treating one condition the related state would also be treated.ObjectivesThis review article will evaluate the various theories relating to the use of antidepressant drugs as smoking cessation aids and the underlying mechanisms link tobacco smoking and depression to explain the action of antidepressants in smoking cessation. One plausible theory of self-medication which proposes that people take nicotine to treat their own depressive symptoms and the affective withdrawal symptoms seen with abstinence from the drug. If the depression can instead be treated with antidepressants, then they may stop smoking altogether. Another theory is that the neurobiological pathways underlying smoking and depression may be similar. By targeting the pathways of depression in the brain, antidepressants would also treat the pathways affected by smoking and ease nicotine cravings and withdrawal. The role of genetic variation predisposing an individual to depression and initiation of tobacco smoking has also been discussed as a potential link between the two conditions. Such variation could either occur within the neurobiological pathways involved in both disorders or it could lead to an individual being depressed and self-medicating with nicotine.

Shame mediates the relationship between depression and addictive behaviours

BackgroundAlcohol and gambling problems are common in young adults. Self-medication theory states that young adults with depression drink and/or gamble to escape negative emotions. Research shows that depression is a risk factor for drinking/gambling problems, but more work is needed to examine mediators underlying these associations. One potential mediator is shame. Shame is a self-directed emotion that follows a negative life event and is characterized by intense feelings of inferiority, worthlessness, and embarrassment. Depressed individuals are especially susceptible to shame (and associated emotions). Shame has also been implicated in risk for addiction. Accordingly, we predicted that elevated shame would explain why depression is associated with both alcohol and gambling problems. MethodsA longitudinal design was used to examine this hypothesis. Undergraduates (N = 210) completed self-reports of depression at baseline (Time 1) and then completed self-reports of shame, alcohol misuse, gambling problems one month later (Time 2). ResultsResults showed that individuals with elevated depression at Time 1 endorsed high levels of shame at Time 2, which in turn predicted more gambling (β = .038, 95% CI [.010, .087]) and alcohol problems (β = .249, 95% CI [.123, .435]) at Time 2. We found that increased levels of shame explained the effects of depression on problem drinking and gambling. ConclusionsStudy findings improve our understanding of the depressive pathway to addiction by providing evidence for shame as a potential mechanism of this pathway. ImpactReducing shame can be a target of clinical interventions for young adults with depression and alcohol/gambling problems.