Background There are elevated rates of comorbid psychiatric disorders among individuals with substance dependence; however, little research examines these rates within inpatient settings, particularly in relation to gender and type of substance. The current study aimed to fill this gap. Method 465 patients (71.4% male) were recruited from an inpatient substance use treatment facility from 2006 to 2009. These patients were interviewed and diagnosed using the Structure Clinical Interview for DSM-IV and the Diagnostic Interview for Personality Disorders. Results 60.6% of patients with substance dependence had a current comorbid psychiatric disorder, and more than 30% had at least two psychiatric disorders. The most common current Axis I diagnosis was major depressive disorder (25.8%), followed by PTSD (14%). Comparable rates were found for Antisocial and Borderline Personality Disorders. Females were significantly more likely to meet diagnostic criteria for a psychiatric disorder than were males (73.7% versus 55.4%). When examining comorbidities across different substance dependences, the highest rates of comorbid psychiatric disorders were found among individuals with alcohol dependence (76.8%) and cannabis dependence (76%), although rates were above 60% for cocaine and opioid dependence. Rates of psychiatric diagnoses were significantly lower (27%) among patients who did not meet diagnostic criteria for substance dependence. Conclusions There are particularly elevated rates of psychiatric disorders among individuals with substance dependence in inpatient treatment. These rates differ as a function of substance dependence type and gender, making these factors important to consider when researching and treating this type of population.

The aim of this study was to test two competing theories concerning the trait of urgency: (1) urgency reflects the tendency to act rashly/impulsively when emotional; or (2) urgency reflects a general reflexive responsivity to emotions that can lead either to rash action or ill-advised inaction, and thus to either impulsive behavior or depression. Following prior findings that 5th grade urgency predicted 6th grade impulsive behavior, we tested whether urgency also predicted 6th grade depression (n = 1,906). After controlling for sex, early pubertal onset, 5th grade depression, 5th grade engagement in addictive behaviors, negative affect, positive affect, and other impulsivity-related traits, 5th grade urgency level did predict higher levels of depression at the end of 6th grade. This finding is consistent with the view that urgency can lead either to rash action or ill-advised inaction. Urgency may be of transdiagnostic importance, contributing both to internalizing and externalizing dysfunction.

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Compensatory exercise and fasting behavior, in the absence of binge eating and purging, appear to be important eating disorder behaviors that are associated with dysfunction, but little is known about these behaviors in youth. We studied the trajectories of their development in non-binge eating and non-purging girls during early adolescence. Using a longitudinal design, we assessed 564 girls six times over the three years of middle school (grades 6 through 8) and developed trajectories specifying different developmental patterns in relation to the behaviors. Prior to this period, when the girls were in 5th grade (elementary school), we assessed risk factors to predict girls’ subsequent trajectory group membership. Compensatory exercise trajectory groups included a non-engagement group, a group that increased in the behavior, and a group that decreased in the behavior. There were two fasting trajectory groups, one consistently engaging in the behavior and the other consistently not. Elementary school levels of depression, eating expectancies, and thinness expectancies predicted subsequent trajectory group membership. Risk for compensatory exercise and fasting should be evaluated as early as in 5th grade. Targeted interventions should focus on girls in late elementary school or middle school, as this appears to be a critical developmental and maintenance period for compensatory exercise and fasting behavior.

Background A long line of theoretical and empirical evidence implicates negative reinforcement as a process underlying the etiology and maintenance of risky alcohol use behaviors from adolescence through emerging adulthood. However, the bulk of this literature has relied on self-report measures and there is a notable absence of behavioral modes of assessments of negative reinforcement-based alcohol-related risk-taking. To address this clear gap in the literature, the current study presents the first published data on the reliability and validity of the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS), which is a modified version of the positive reinforcement-based Balloon Analogue Risk Task (BART). Methods Participants included a convenience sample of 116 college freshmen ever regular drinkers (aged 18–19) who completed both behavioral tasks; self-report measures of negative reinforcement/avoidance constructs and of positive reinforcement/appetitive constructs to examine convergent validity and discriminant validity, respectively; and self-report measures of alcohol use, problems, and motives to examine criterion validity. Results The MRBURNS evidenced sound experimental properties and reliability across task trials. In support of convergent validity, risk taking on the MRBURNS correlated significantly with negative urgency, difficulties in emotion regulation and depressive and anxiety-related symptoms. In support of discriminant validity, performance on the MRBURNS was unrelated to risk taking on the BART, sensation seeking, and trait impulsivity. Finally, pertaining to criterion validity, risk taking on the MRBURNS was related to alcohol-related problems but not heavy episodic alcohol use. Notably, risk taking on the MRBURNS was associated with negative reinforcement-based but not with positive reinforcement-based drinking motives. Conclusions Data from this initial investigation suggest the utility of the MRBURNS as a behavioral measure of negative-reinforcement based risk-taking that can provide a useful compliment to existing self-report measures to improve our understanding of the relationship between avoidant reinforcement processes and risky alcohol use.