The Alcohol Purchase Task appears to have good construct validity, but limited incremental utility in estimating risk for alcohol problems.

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Background: Those with misophonia experience distress in response to specific sounds (e.g., sounds of eating) and often to repetitive movements (e.g., seeing leg shaking). The literature on misophonia is sparse but it is gaining increased clinical attention. methods: We report on four cases to highlight clinical characteristics associated with misophonia seen in a pediatric treatment setting. results: Patients typically responded to triggers with avoidant behavior or made attempts to stop the production of the trigger. Misophonia caused varying levels of impairment and was often seen as the patient's primary complaint. Onset began in childhood and demonstrated increasing severity until the point at which evaluation and treatment was sought. Family accommodation was consistently present and reinforced the patient's difficulties. Conclusion: Misophonia is distinguished from existing psychological and auditory disorders that have known etiologies and treatments. Further research is required to understand the neurological and psychological underpinnings of the disorder, and identify appropriate treatments.

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Distress tolerance (DT), or the ability to withstand psychological distress, has been proposed as a mechanism underlying multiple forms of psychopathology. However, research on DT is limited in several areas. First, stability and change of DT over time has never been assessed in adults. Second, it is unclear whether alternative conceptualizations of DT yield differences in longitudinal stability and change. Third, gender differences in DT have yet to be examined in nonclinical adult samples. And fourth, longitudinal predictive utility of DT has not been adequately assessed. The purpose of this study was to investigate these 3 questions using data collected at 3 time points over a 6-month period, examining borderline personality disorder (BPD) features as an outcome. Using 3 different measures of DT, results indicated that there is no mean level change in DT. Similarly, there was moderate rank-order stability in DT and no significant individual level change across measures. These findings suggest that DT is similar to other stable, trait-like constructs, as has been previously theorized. Next, a series of cross-lagged panel models revealed that although DT had a cross-sectional relationship with BPD features across all time points, DT did not predict BPD traits longitudinally. These findings have implications for treatments for BPD.

Although borderline personality disorder (BPD) traits decline from adolescence to adulthood, comorbid psychopathology such as symptoms of major depressive disorder (MDD), alcohol use disorder (AUD), and drug use disorders (DUDs) likely disrupt this normative decline. Using a longitudinal sample of female twins (N = 1,763), we examined if levels of BPD traits were correlated with changes in MDD, AUD, and DUD symptoms from ages 14–24. A parallel process biometric latent growth model examined the contributions of genetic and environmental factors to the relationships between developmental components of these phenotypes. Higher BPD trait-levels predicted a greater rate of increase in AUD and DUD symptoms, and higher AUD and DUD symptoms predicted a slower rate of decline of BPD traits from ages 14–24. Common genetic influences accounted for the associations between BPD traits and each disorder, as well as the interrelationships of AUD and DUD symptoms. Both genetic and nonshared environmental influences accounted for the correlated levels between BPD traits and MDD symptoms, but solely environmental influences accounted for the correlated changes between the two over time. Results indicate that higher levels of BPD traits may contribute to an earlier onset and faster escalation of AUD and DUD symptoms, and substance use problems slow the normative decline in BPD traits. Overall, our data suggests that primarily genetic influences contribute to the comorbidity between BPD features and substance use disorder symptoms. We discuss our data in the context of two major theories of developmental psychopathology and comorbidity.

Smokers with stronger neuroaffective responses to drug-related cues compared to nondrug-related pleasant images (C > P) are more vulnerable to compulsive smoking than individuals with the opposite brain reactivity profile (P > C). However, it is unknown if these neurobehavioral profiles exist in individuals abusing other drugs. We tested whether individuals with cocaine use disorder (CUD) show similar neuroaffective profiles to smokers. We also monitored eye movements to assess attentional bias toward cues and we further performed exploratory analyses on demographics, personality, and drug use between profiles. Participants with CUD (n = 43) viewed pleasant, unpleasant, cocaine, and neutral images while we recorded electroencephalogram. For each picture category, we computed the amplitude of the late positive potential (LPP), an event-related potential component that reflects motivational relevance. k-means clustering classified participants based on their LPP responses. In line with what has been observed in smokers, clustering participants using LPP responses revealed the presence of two groups: one with larger LPPs to pleasant images compared to cocaine images (P > C) and one group with larger LPPs to cocaine images compared to pleasant images (C > P). Individuals with the C > P reactivity profile also had higher attentional bias toward drug cues. The two groups did not differ on demographic and drug use characteristics, however individuals with the C > P profile reported lower distress tolerance, higher anhedonia, and higher posttraumatic stress symptoms compared to the P > C group. This is the first study to report the presence of these neuroaffective profiles in individuals with CUD, indicating that this pattern may cut across addiction populations. Public SignificanceOur findings suggest that heterogeneity in psychophysiological responses to cocaine-related and noncocaine-related emotional cues can be linked to behaviors associated with individual differences the tendency to attribute incentive salience to cues. Consideration of these psychophysiological individual differences during treatment may help clinicians tailor treatments and increase treatment success.