Mental Health Research in Correctional Settings: Perceptions of Risk and Vulnerabilities

With more than half of individuals incarcerated having serious mental health concerns, correctional settings offer excellent opportunities for epidemiological, prevention, and intervention research. However, due to unique ethical and structural challenges, these settings create risks and vulnerabilities for participants not typically encountered in research populations. We surveyed 1,224 researchers, Institutional Review Board (IRB) members, and IRB prisoner representatives to assess their perceptions of risks and vulnerabilities associated with mental health research conducted in correctional settings. Highest ranked risks were related to privacy, stigma, and confidentiality; lowest ranked risks were related to prisoners’ loss of privileges or becoming targets of violence due to having participated in research. Cognitive impairment, mental illness, lack of autonomy, and limited access to services emerged as the greatest sources of vulnerability; being male, being female, being older than age 60, being a minority, and being pregnant were the lowest ranked sources of vulnerability. Researchers with corrections experience perceived lower risks and vulnerabilities than all other groups, raising the question whether these researchers accurately appraise risk and vulnerability based on experience, or if their lower risk and vulnerability perceptions reflect potential bias due to their vested interests. By identifying areas of particular risk and vulnerability, this study provides important information for researchers and research reviewers alike.     

Negative cognitive style and looming cognitive style synergistically predict stress generation

There is a growing body of evidence that suggests that cognitive vulnerabilities to depression or anxiety may lead individuals to generate negative interpersonal life events. However, there has been no study to date that examines the effects of co-occurring vulnerabilities to depression and anxiety. In a sample of 304 participants, we examined the potential interaction of co-occurring negative cognitive style, a vulnerability to depression and looming cognitive style, vulnerability to anxiety. Results indicate that co-occurring cognitive vulnerabilities synergistically predict higher levels of negative interpersonal life events six weeks later, even when controlling for initial levels of stressful life events and symptoms of depression and anxiety. Thus, co-occurring vulnerabilities may have stronger stress generating effects than would be expected from the additive effects of each vulnerability considered separately. This finding highlights the importance of examining cognitive vulnerabilities as interactive effects rather than as individual vulnerabilities.     

Consumer financial planning in the post-Covid-19 era: The role of emotional and economic vulnerability

The present research examines the relationship between emotional vulnerability, economic vulnerability, and intentions to improve financial planning for American households in the post-Covid-19 era. Using a survey of 504 household financial decision markers, we show that the effects of psychological fears and concerns experienced during the pandemic (i.e., emotional vulnerability) on post-pandemic household financial planning intentions are mediated by their perceived economic vulnerability. Specifically, for those who experience higher levels of emotional vulnerability, economic vulnerabilities are perceived to be harsher, further motivating them to raise their financial preparedness. Moreover, we identify an individual factor, personality trait of conscientiousness, as a boundary condition affecting this relationship. Specifically, individuals who are more conscientious tend to be more willing to learn from harsh pandemic experiences and are more willing to adapt in the long run.     

Aberrant learning and memory in addiction

Over the past several years, drug addiction has increasingly been accepted to be a disease of the brain as opposed to simply being due to a lack of willpower or personality flaw. Exposure to addictive substances has been shown to create enduring changes in brain structure and function that are thought to underlie the transition to addiction. Specific genetic and environmental vulnerability factors also influence the impact of drugs of abuse on the brain and can enhance the likelihood of becoming an addict. Long-lasting alterations in brain function have been found in neural circuits that are known to be responsible for normal appetitive learning and memory processes and it has been hypothesized that drugs of abuse enhance positive learning and memory about the drug while inhibiting learning about the negative consequences of drug use. Therefore, the addict's behavior becomes increasingly directed towards obtaining and using drugs of abuse, while at the same time developing a poorer ability to stop using, even when the drug is less rewarding or interferes with functioning in other facets of life. In this review we will discuss the clinical evidence that addicted individuals have altered learning and memory and describe the possible neural substrates of this dysfunction. In addition, we will explore the pre-clinical evidence that drugs of abuse cause a progressive disorder of learning and memory, review the molecular and neurobiological changes that may underlie this disorder, determine the genetic and environmental factors that may increase vulnerability to addiction, and suggest potential strategies for treating addiction through manipulations of learning and memory.     

Perspectives on current directions in the neurobiology of addiction disorders relevant to genetic risk factors

There is a significant heritability of drug addiction disorders, but potential genes that may underlie such vulnerability have not been clearly identified. Common neurobiological candidates for drug abuse include genes related to dopamine, opioid neuropeptide, and glutamate transmission that play important roles in drug reward and inhibitory control. This article provides an overview of genetic polymorphisms linked to these neurobiological systems, particularly in relation to psychostimulant- and opioid-addiction vulnerability.     

The Role of Meditation in Addiction Recovery

The authors examined the role of meditation as an important component in addiction recovery. Successful addiction recovery is often related to an individual's ability to develop and use a repertoire of coping behaviors, including the ability to maintain an ongoing awareness of one's vulnerability. These learned behaviors serve as reliable alternatives to the routine behavior patterns of individuals who are addicted, which, in the past, have led to often‐repeated destructive outcomes. The authors contend that incorporating meditation into the lifestyle of individuals recovering from addiction provides a consistent means of preparing for inevitable, addiction‐related life challenges and a coping skill that can help maintain equilibrium in living with ever‐present peril.     

Race,psychosocial vulnerability and social support differences in inner-city women's symptoms of posttraumatic stress disorder

Background/Objectives: Inner-city Black women may be more susceptible to posttraumatic stress disorder (PTSD) than White women, although mechanisms underlying this association are unclear. Living in urban neighborhoods distinguished by higher chronic stress may contribute to racial differences in women's cognitive, affective, and social vulnerabilities, leading to greater trauma-related distress including PTSD. Yet social support could buffer the negative effects of psychosocial vulnerabilities on women's health. Methods/Design: Mediation and moderated mediation models were tested with 371 inner-city women, including psychosocial vulnerability (i.e., catastrophizing, anger, social undermining) mediating the pathway between race and PTSD, and social support moderating psychosocial vulnerability and PTSD. Results: Despite comparable rates of trauma, Black women reported higher vulnerability and PTSD symptoms, and lower support compared to White Hispanic and non-Hispanic women. Psychosocial vulnerability mediated the pathway between race and PTSD, and social support moderated vulnerability, reducing negative effects on PTSD. When examining associations by race, the moderation effect remained significant for Black women only. Conclusions: Altogether these psychosocial vulnerabilities represent one potential mechanism explaining Black women's greater risk of PTSD, although cumulative psychosocial vulnerability may be buffered by social support. Despite higher support, inner-city White women's psychosocial vulnerability may actually outweigh support's benefits for reducing trauma-related distress.     

强迫性特征在药物成瘾行为中的易感性及其前额叶-反奖赏系统神经基础

强迫性是一种与不顾严重后果的固着行为密切相关的神经心理结构, 大脑神经系统对强迫性行为的调控机制崩溃是导致药物成瘾的直接原因。以往研究对于奖赏系统(中脑-皮层-边缘神经环路)在成瘾行为中的作用及机制已经具有丰富的了解, 但针对药物成瘾的强迫性特征本身以及前额叶-反奖赏系统神经环路在成瘾行为中的作用机制了解有限, 尤其是缺乏对药物成瘾强迫性特征的系统考察、缺少遗传学研究以及非兴奋剂类药物的汇聚证据。项目拟结合人类成瘾行为的遗传学视角(海洛因成瘾者与其无药物使用的兄弟姐妹对照), 结合神经认知、脑电生理、神经影像等不同层面的方法和技术, 对药物成瘾强迫性的外在表征、神经生物学基础以及与个体差异有关的遗传易感性进行探索, 期在进一步识别药物成瘾的神经生物标记, 为探寻潜在的药物或非药物干预靶点提供更多证据。     

Pathological Women Gamblers: Gender-Related Aspects of Control

This study examines the control exhibited by pathological women gamblers over their lives and their surroundings, and how this is governed by their perception of their gender role and socio-cultural expectations of them as women. Seventeen pathological women gamblers (13 of whom were mothers) were recruited from three addiction treatment centers in Israel, and participated in semi-structured interviews. Three central themes emerged during analysis: maintaining control over the gender roles—putting child raising and housekeeping duties first despite their gambling habits; control over the choice of gambling venue—gambling far from their home, or where they knew the owners; and moral control—steering clear of immoral behaviors in spite of their addiction to gambling. Further analysis reveals how pathological women gamblers who are also mothers make rational choices that help them juggle between their gender roles and gambling, to minimize the social costs that might be incurred by their gambling habit. Moreover, presenting the gambling behavior as more moral than theft or prostitution enabled them to normalize their behavior. The study’s findings show how the decisions and choices made by the women in this study are shaped by the socio-cultural context in which they are made.     

Processus et subjectivité dans l’addiction

Addictive behaviors point out difficulties in definition and conceptualization. Emotion in its different forms is one of the most important phenomenon in the dynamic of addictions. We question the nature of the act, its economical status and its adaptative value. Moreover, we question the individual vulnerability and behavior's effects. The most important difficulty is to propose a general model of addiction, which can put together and explain the different forms of addictive behaviours. Those have to describe behaviour and its relationships with the individual's functioning, like subjectivity. We tend to propose in this paper such a model and insist on a particular economical system in the addiction.     

冲动性对不同成瘾行为发展的调控及其神经机制

近年来越来越多的研究证据提示, 个体冲动性在成瘾疾患发生发展机制中具有关键作用, 可能成为成瘾行为的潜在易感标记以及早期识别和干预的重要靶点, 但冲动性对不同成瘾行为变化发展的调控机制尚不明确。项目拟综合跨成瘾谱系比较、纵向追踪设计、冲动行为干预等研究途径, 采用人格测量、神经认知、神经影像等技术, 首先比较尼古丁依赖者与网络游戏成瘾者的冲动性结构及其在前额叶–纹状体环路的结构功能改变; 然后采用混合分组设计筛选出具有高低冲动性的非成瘾青少年进行连续追踪研究, 考察冲动性对尼古丁依赖与网络游戏成瘾的预测效力; 并采用认知行为训练, 对吸烟成瘾者与网络游戏成瘾者进行冲动干预, 考察行为干预对冲动性水平及前额叶–纹状体环路功能的改变, 以及对不同成瘾行为发展的抑制后效。旨在探索冲动性作为成瘾的潜在易感标记及干预靶点的效力。     

Predicting Behavior From Actions in the Past: Repeated Decision Making or a Matter of Habit?

This paper summarizes research on determinants of repeated behaviors, and the decision processes underlying them. The present research focuses on travel mode choices as an example of such behaviors. It is proposed that when behavior is performed repeatedly and becomes habitual, it is guided by automated cognitive processes, rather than being preceded by elaborate decision processes (i.e., a decision based on attitudes and intentions). First, current attitude-behavior models are discussed, and the role of habit in these models is examined. Second, research is presented on the decision processes preceding travel mode choices. Based on the present theoretical and empirical overview, it is concluded that frequently performed behavior is often a matter of habit, thereby establishing a boundary condition for the applicability of attitude-behavior models. However, more systematic research is required to disentangle the role of habit in attitude-behavior models and to learn more about the cognitive processes underlying habitual behavior.     

Drug Court as Both a Legal and Medical Authority

This article explores how addiction is conceptualized in a drug court program. Through observations and interviews in a drug court in a large northeastern city, the author reveals how the court uses ambiguous and inconsistent medicalized language to describe addiction, extending the label of addiction to behaviors not just associated with using drugs, but with selling drugs as well. Ultimately, drug courts incorporate a medicalized notion of addiction to further their own control over drug-related issues, since they become the authority of both the client's treatment and their punishment.     

Anxiety sensitivity and risk-taking behavior

High trait anxiety has been linked with risk-avoidant decision-making, though little is known regarding the specific facets of anxiety contributing to this negative association. Anxiety sensitivity (AS), a transdiagnostic vulnerability factor for anxiety-related pathology, may be particularly relevant to risk decision-making given that risk-taking behaviors generate heightened somatic arousal and produce many of the sensations feared by individuals with high AS. Two studies were conducted to investigate the relation between AS and risk decision-making. In the first study, 268 undergraduate students completed a series of questionnaires that included measures of AS and gambling behaviors. Significant negative correlations were observed between AS and several gambling-related risk-taking activities, and hierarchical multiple regression analyses indicated that AS scores added significant incremental validity in predicting risk-taking over and above demographic variables, negative affect, and trait anxiety. In the second study, 43 participants who had screened for high (n = 20) or low (n = 23) AS completed the Iowa gambling task, a behavioral measure of risk-taking. Results indicated that, when placed under conditions of risk, individuals with high AS engaged in significantly less risk-taking than their low AS counterparts. The implications of these findings and potential directions for future research are discussed.     

Family, personality, and social risk factors impacting the retention rates of first-year Hispanic and Anglo college students

This study investigated familial and behavioral differences between Hispanic and Anglo-American first-year college students. Analyses of variance and chi-square analyses were used to test for ethnic differences in (a) risk factors associated with family dysfunction, family addictions, personality factors, and social experiences, (b) student problem behaviors, namely alcohol use, drug use, and eating disorders, (c) a one-year follow-up of student retention, and (d) specific factors related to retention at the one-year follow-up. The Hispanic freshmen appeared to demonstrate resilience despite a lack of mentoring and greater paternal addiction. However, the one-year follow-up suggested that Hispanic females were at particular risk for leaving school. To improve college retention rates, social policy should focus on Hispanic students' vulnerabilities and strengths in making important developmental transitions.     

Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory

The ascendance of emotion theory, recent advances in cognitive science and neuroscience, and increasingly important findings from developmental psychology and learning make possible an integrative account of the nature and etiology of anxiety and its disorders. This model specifies an integrated set of triple vulnerabilities: a generalized biological (heritable) vulnerability, a generalized psychological vulnerability based on early experiences in developing a sense of control over salient events, and a more specific psychological vulnerability in which one learns to focus anxiety on specific objects or situations. The author recounts the development of anxiety and related disorders based on these triple vulnerabilities and discusses implications for the classification of emotional disorders.     

The vulnerability cycle: working with impasses in couple therapy

In this article, we propose the vulnerability cycle as a construct for understanding and working with couples' impasses. We expand the interactional concept of couples' reciprocal patterns to include behavioral and subjective dimensions, and articulate specific processes that trigger and maintain couples' entanglements. We consider the vulnerability cycle as a nexus of integration in which "vulnerabilities" and "survival positions" are key ideas that bring together interactional, sociocultural, intrapsychic, and intergenerational levels of meaning and process. The vulnerability cycle diagram is presented as a tool for organizing information. We suggest a therapeutic approach for deconstructing couples' impasses and facilitating new patterns through deliberate modes of questioning, a freeze-frame technique, stimulation of calmness and reflection, separating present from past, and elicitation of alternative meanings, behaviors, empathy, and choice. This approach encourages the therapist and couple to work collaboratively in promoting change and resilience.