Emotion Dysregulation in Comorbid Posttraumatic Stress Disorder and Substance Use Disorders: A Narrative Review

Co-occurrence of substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) is extremely common and is associated with elevated dropout and relapse rates. Given that PTSD/SUD co-occurrence rates among veterans have been found to be as high as 55?75%, it is important to identify mechanisms that may affect the interplay of both disorders. Emotion dysregulation (ED) presents a candidate mechanism that may underlie poor treatment response in co-occurring PTSD/SUD. This article proposes a transdiagnostic emotion regulation framework that considers ED conceptualized as a combination of low ability to tolerate emotional distress (low distress tolerance) and difficulties in the goal-directed use of emotion regulation strategies as a key risk factor in co-occurring PTSD/SUD. The authors review empirical findings from self-report and laboratory-based studies of ED in PTSD. They describe psychological explanations of the emotion-substance relationship and review studies documenting ED in SUDs and in co-occurring PTSD/SUD. The literature on ED in PTSD/SUD suggests that (a) patients with PTSD may resort to substances to cope with trauma-related symptoms due to ED, and (b) ED may maintain SUD symptoms and interfere with psychological treatment. Longitudinal studies on bidirectional relationships between ED and substance use in PTSD are needed, particularly research examining the course of ED in PTSD patients who use substances versus those who do not.     

Exploring the modulation of attentional capture by attentional control settings using performance and illusory line motion

Modulation of attentional capture by attentional control settings was explored using performance and phenomenology. Trials began with four figure-8s presented above, below, left, and right of fixation. Any figure-8 (or none) brightened uninformatively (cue) before presentation of either a digit target (2 or 5 made from a figure-8 by deletion) calling for a speeded identification, or a line connecting adjacent figure-8s calling for a motion judgement. Such lines are seen drawn away from an adjacent cue. Digit targets appeared only on the horizontal or vertical axes, encouraging voluntary attention to two (target-relevant) of the four figure-8s. Whereas voluntary attention reduced attentional capture from cues at taskirrelevant locations (when lines were unlikely to be presented near the task-irrelevant locations), it had no effect on motion judgements, suggesting that cue-elicited exogenous attention affects perceptual arrival times while voluntary attention prioritizes locations for further processing without affecting arrival times.     

IN DEFENSE OF THE BODY: THE EFFECT OF MORTALITY SALIENCE ON FEMALE BODY OBJECTIFICATION

Previous research has illustrated the negative psychological consequences of female body objectification. The present study explores how female body objectification may serve as a defense against unconscious existential fears. Drawing from terror management theory, an experiment was designed to test the potential functionality of female body objectification. Men and women were primed to think about either their own mortality or an aversive control topic, and levels of body objectification were then assessed for both self- and other (women)-objectification. Findings supported the hypothesis that priming mortality would increase both self- and other-objectification among women, and self-objectification among those who derive self-esteem from their body. Implications for this research are discussed.     

Attentional effects on orientation judgements are dependent on memory consolidation processes

Are the effects of memory and attention on perception synergistic, antagonistic, or independent? Tested separately, memory and attention have been shown to affect the accuracy of orientation judgements. When multiple stimuli are presented sequentially versus simultaneously, error variance is reduced. When a target is validly cued, precision is increased. What if they are manipulated together? We combined memory and attention manipulations in an orientation judgement task to answer this question. Two circular gratings were presented sequentially or simultaneously. On some trials a brief luminance cue preceded the stimuli. Participants were cued to report the orientation of one of the two gratings by rotating a response grating. We replicated the finding that error variance is reduced on sequential trials. Critically, we found interacting effects of memory and attention. Valid cueing reduced the median, absolute error only when two stimuli appeared together and improved it to the level of performance on uncued sequential trials, whereas invalid cueing always increased error. This effect was not mediated by cue predictiveness; however, predictive cues reduced the standard deviation of the error distribution, whereas nonpredictive cues reduced “guessing”. Our results suggest that, when the demand on memory is greater than a single stimulus, attention is a bottom-up process that prioritizes stimuli for consolidation. Thus attention and memory are synergistic.     

Comparing the mental health needs of female and male incarcerated juvenile delinquents

The present study was undertaken to survey the prevalence of mental disorder in juvenile justice facilities and to compare the mental health needs for females and males. Girls displayed significantly more mental health needs than boys. The estimated prevalence of mental disorder for boys was 27%, compared with 84% for girls. The difference is highly significant and is discussed in terms of service system issues in juvenile justice that affect males and females differently. ©1997 John Wiley & Sons, Ltd.     

Cultural Differences in the Subjective Experience of Emotion: When and Why They Occur

Cross‐cultural comparisons of subjective emotional experience are common, and virtually any comparison of nations or different ethnic groups is bound to yield some differences and some similarities. While nobody doubts the considerable intercultural variability in subjective or self‐reports of emotion, more attention needs to be given to when and why and these differences occur. In this article, we explore factors that accentuate or attenuate cultural differences in the subjective experience of emotion. We propose that cultural norms shape emotional experiences to different degrees depending on the time frame of the emotional experience, the valence of the emotion, and even the specific emotion being compared. We review the research that supports this view and we highlight new avenues of research that are likely to shed light on cultural differences in the subjective experience of emotions.     

‘What made me unhappy’. Experiences of,and responses to,lifestyle changes in breast cancer patients

Sixteen breast cancer patients were interviewed about any lifestyle changes they had experienced and their reactions to those changes. Data were collected and analysed via content analysis and then summary tabulations of patient responses until replication of responses was verified across patients. Results indicated that most patients suffered a reduction in recreation activities, unpleasant physical side effects from treatment and loss of feminine appearance characteristics, all of which were seen as decreases in previously available and valuable sources of social support and self-esteem. In response to these losses, patients reported a common coping strategy of avoidance or escape similar to some depressive symptomatology. Implications for counsellors are discussed.     

Test of Alternative Hypotheses Explaining the Comorbidity Between Attention-Deficit/Hyperactivity Disorder and Conduct Disorder

There is significant comorbidity between attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD). The conclusions of studies that examined the causes of comorbidity between ADHD and CD conflict, with some researchers finding support for the three independent disorders model and others finding support for the correlated risk factors model. We tested these models and eleven alternative hypotheses using the same analytical approach. The participants were 110 monozygotic twin pairs and 181 dizygotic twin pairs recruited from the Colorado Learning Disabilities Research Center Twin Study. The three independent disorders model did not fit the data, whereas the correlated risk factors model fit the data well. Several other comorbidity models fit the data as well as or better than the correlated risk factors model. The results suggest that correlated risk factors are a better explanation for the comorbidity between ADHD and CD than a third, independent ADHD+CD subtype.