Emotion regulation and substance use: A meta-analysis

Weiss, Nicole H.; Kiefer, Reina; Goncharenko, Svetlana; Raudales, Alexa M.; Forkus, Shannon R.; Schick, Melissa R.; Contractor, Ateka A.

doi:10.1016/j.drugalcdep.2021.109131

Cited by 91 publications

(59 citation statements)

References 162 publications

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“…Second, investigations of emotion dysregulation and substance use have almost exclusively focused on dysregulation stemming from negative emotional experiences. However, dysregulation manifests across both negative and positive emotional systems [47, 48], and early cross‐sectional findings provide support for the role of positive emotion dysregulation in PTSD [49–52], substance use [48,53–58], and the PTSD‐substance use association [59]; many of these studies are of women experiencing IPV. These findings suggest that positive emotion dysregulation may also contribute to substance use among women experiencing IPV with PTSD.…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro‐longitudinal study of community women experiencing intimate partner violence

et al. 2022

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Background and Aims A fast‐growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross‐sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post‐traumatic stress disorder (PTSD). Design Micro‐longitudinal momentary data were collected three times per day for 30 days using phone‐based interactive voice recording. Setting Northeastern United States. Participants A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020. Measurements Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview. Findings Between‐person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within‐person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation. Conclusions Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro‐longitudinal study of community women experiencing intimate partner violence

et al. 2022

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“…Cognitive dysfunction has been identified as a predictor of poor emotional perception among opioid-dependent individuals on MOUD ( 17 ). This poor emotional perception impacts patients ability to differentiate between positive and negative feelings of behavior, decreasing the ability to make rational decisions in regard to preventative behaviors ( 18 ). It can also adversely impact treatment outcomes ( 10 , 14 ) such as treatment compliance, willingness to start and stay in treatment, attendance at behavioral intervention sessions, and lack of perspective on the benefits of treatment ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder

Mistler

Idiong

Copenhaver

2022

Front. Public Health

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BackgroundCognitive dysfunction is disproportionately prevalent among persons with opioid use disorder (OUD). Specific domains of cognitive dysfunction (attention, executive functioning, memory, and information processing) may significantly impede treatment outcomes among patients on medication for OUD (MOUD). This limits patient's ability to learn, retain, and apply information conveyed in behavioral intervention sessions. Evidence-based accommodation strategies have been integrated into behavioral interventions for other patient populations with similar cognitive profiles as persons with OUD; however, the feasibility and efficacy of these strategies have not yet been tested among patients on MOUD in a drug treatment setting.MethodsWe conducted a series of focus groups with 25 key informants (10 drug treatment providers and 15 patients on MOUD) in a drug treatment program in New Haven, CT. Using an inductive approach, we examined how cognitive dysfunction impedes participant's ability to retain, recall, and utilize HIV prevention information in the context of drug treatment.ResultsTwo main themes capture the overall responses of the key informants: (1) cognitive dysfunction issues and (2) accommodation strategy suggestions. Subthemes of accommodation strategies involved suggestions about particular evidence-based strategies that should be integrated into behavioral interventions for persons on MOUD. Specific accommodation strategies included: use of a written agenda, mindfulness meditation, multi-modal presentation of information, hands-on demonstrations, and a formal closure/summary of sessions.ConclusionsAccommodation strategies to compensate for cognitive dysfunction were endorsed by both treatment providers and patients on MOUD. These accommodation strategies have the potential to enhance the efficacy of behavioral interventions to reduce HIV transmission among persons on MOUD as well as addiction severity, and overdose.

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“…Individuals with versus without AUD report elevated emotion dysregulation (Fox et al, 2008). Cross‐sectional studies have found elevated emotion dysregulation to be correlated with more alcohol use and alcohol‐related problems (see Weiss et al, 2022a for meta‐analytic review). Finally, improvements in emotion dysregulation have been shown to predict reductions in alcohol use following treatment (Axelrod et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, emotion dysregulation refers to the typical or dispositional ways in which individuals understand, regard, and respond to their emotions, and therefore reflects their abilities (or potential) for emotion regulation (Gratz & Roemer, 2004), whereas emotion regulation strategies refer to specific tactics individuals use (e.g., reappraisal and suppression) to influence the experience and expression of their emotions (Gross, 2015). Notably, ability and strategy models capture distinct aspects of emotion regulation (Tull & Aldao, 2015), and meta‐analytic review suggests that emotion dysregulation is more strongly related to substance (e.g., alcohol) use than emotion regulation strategies (Weiss et al, 2022a). Thus, the use of ESMs will significantly advance understanding of the association between emotion dysregulation and alcohol use, generally and among women experiencing IPV in particular.…”

Section: Introductionmentioning

confidence: 99%

“…Emotion dysregulation is a multi-faceted construct involving: (a) a lack of awareness, understanding, and acceptance of emotions; (b) an inability to control behaviors when experiencing emotions; (c) limited access to situationally appropriate strategies for modulating emotions; and (d) an unwillingness to experience emotions as part of pursuing meaningful activities in life (Gratz & Roemer, 2004). Emotion dysregulation has consistently emerged as an important factor contributing to the etiology and maintenance of alcohol use (Weiss et al, 2022a), including among IPV-victimized women (Weiss et al, 2018a(Weiss et al, , 2022b. Individuals with versus without AUD report elevated emotion dysregulation (Fox et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro‐longitudinal study

Weiss

Brick

Goldstein

et al. 2022

Alcoholism Clin & Exp Res

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Background: Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level.Methods: Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording.Results: Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects.Conclusions: Findings showed that negative and positive emotion dysregulation cooccurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

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Emotion regulation and substance use: A meta-analysis

Cited by 91 publications

References 162 publications

Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro‐longitudinal study of community women experiencing intimate partner violence

Posttraumatic stress disorder strengthens the momentary associations between emotion dysregulation and substance use: a micro‐longitudinal study of community women experiencing intimate partner violence

Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder

Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro‐longitudinal study

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