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.     

Rethinking Epistemic Relativism

“Relativism” is often treated as a dirty word in philosophy, but relativistic theories are not entirely unappealing—they have features that might be tempting if they weren't thought to be outweighed by problematic consequences. The aim of this paper is to rethink both our attitude to epistemic relativism and the basic features of the view itself. The paper discusses four objections and uses them to isolate five constraints on a more plausible epistemic relativism. It then sketches out a view that meets all of these constraints. This stratified epistemic relativism offers a complex, socially informed picture of justification that accounts for the many different kinds of roles that epistemic agents act, and think, in accordance with each day, and can serve as a starting point for constructing a more detailed epistemic relativism, which could secure its appealing benefits without incurring the costs traditionally associated with relativist views.     

Belief and credence: why the attitude-type matters

Philosophical Studies - In this paper, I argue that the relationship between belief and credence is a central question in epistemology. This is because the belief-credence relationship has...     

The effects of verbal reinforcement of intrinsic motivation for sex-linked tasks

Recent studies have demonstrated that positive verbal feedback enhances males' intrinsic motivation for a task, while decreasing that of females. This result has been attributed to differential socialization forces which make the controlling aspects of rewards more salient for females as opposed to males, for whom the informational aspects are prepotent. A weakness in this conclusion stems from the use of a masculine sex-linked task in prior experiments, producing a result which may be due to gender congruence/incongruence rather than to socialization differences. Two laboratory experiments were performed to examine the effects of verbal praise on intrinsic motivation, controlling for sex-typing of the experimental activity. Experiment I found that verbal praise increased females' and males' intrinsic motivation on both a feminine and masculine task, and intrinsic motivation was higher for sex-appropriate than sex-inappropriate tasks. The sexes did not show a differential pattern of response to praise. In Experiment 2, verbal praise also enhanced sex-role traditional females' intrinsic motivation on the same activity used in prior research. These results suggest that socialization content has changed sufficiently to make concerns about competence and self-determination equally salient for females and males.     

The longitudinal effects of early identification and counseling of underachievers

This study examined the effects of early identification and psychological services on underachievement through a follow-up study conducted six years later. One hundred and seventeen fourth-grade underachievers had been identified through a regression equation and were divided into experimental and control groups. The experimental group received psychological services during their fourth, fifth, and sixth grades from a team of university professors. Psychological services were primarily adult centered, focusing on the redirection of parents and teachers who were the primary influence on the lives of these underachievers. Follow-up studies of them at high school graduation indicated that differences between these groups reached at least the .05 level of significance for class rank, the ACT composite, the ITED composite and its subtests, and level of educational and vocational performance after high school graduation. Differences which were not statistically significant were found for pregraduation aspirations for the immediate future.     

Social cues, cognitive style, error magnitude, and male performance on the Felt Figure Replacement Technique.

A series of studies was undertaken to determine possible factors contributing to low predictive utility for Felt Figure Replacement Technique (FFRT) scores from normal, adult males. It was first postulated that normal adult males, compared to normal adult females, are less sensitive to social cues present in the FFRT task. Twenty-six undergraduate males and the same number of undergraduate females were asked to replace both a) department store manikins, thought to be less abstract, and then b) felt figures. While task differences were obtained, these were not dependent on gender, nor did any overall gender differences occur for three types of replacement error. The second study involved 31 college males and 33 college females replacing both felt figures and a male and female confederate. It was assumed that differential attention to social cues would be more visible in this comparison. The general results were identical to the first study.     

Images of the self and self-esteem: do positive self-images improve self-esteem in social anxiety?

Negative self-images play an important role in maintaining social anxiety disorder. We propose that these images represent the working self in a Self-Memory System that regulates retrieval of self-relevant information in particular situations. Self-esteem, one aspect of the working self, comprises explicit (conscious) and implicit (automatic) components. Implicit self-esteem reflects an automatic evaluative bias towards the self that is normally positive, but is reduced in socially anxious individuals. Forty-four high and 44 low socially anxious participants generated either a positive or a negative self-image and then completed measures of implicit and explicit self-esteem. Participants who held a negative self-image in mind reported lower implicit and explicit positive self-esteem, and higher explicit negative self-esteem than participants holding a positive image in mind, irrespective of social anxiety group. We then tested whether positive self-images protected high and low socially anxious individuals equally well against the threat to explicit self-esteem posed by social exclusion in a virtual ball toss game (Cyberball). We failed to find a predicted interaction between social anxiety and image condition. Instead, all participants holding positive self-images reported higher levels of explicit self-esteem after Cyberball than those holding negative self-images. Deliberate retrieval of positive self-images appears to facilitate access to a healthy positive implicit bias, as well as improving explicit self-esteem, whereas deliberate retrieval of negative self-images does the opposite. This is consistent with the idea that negative self-images may have a causal, as well as a maintaining, role in social anxiety disorder.     

Confidence to Foster Across Cultures: Caregiver Perspectives

It is important to understand how cultural values, beliefs and traditions of foster parents are related to placement success because a substantial proportion of children in care come from culturally diverse backgrounds. In the present study participants were asked about resources they saw as necessary to improve their confidence fostering children from culturally diverse backgrounds. Sixty-one foster parents from a central Canadian province participated in a telephone interview that included the question: “what would help you feel more confident about fostering children with different values, beliefs and traditions?” A total of 35 unique responses were obtained and grouped together by 13 foster parents. Multidimensional scaling and cluster analysis were used to analyze the grouping data. Foster parents described six themes: understanding different cultures, training, self awareness, agency support, open discussion and community services. There were several similarities and differences between the perspectives of foster parents interviewed and the literature. Implications for future research are discussed.     

Endorsement of Group Change and Organization Change Affirmative Action Programs for Male and Female Beneficiaries

To test the position that some people’s willingness to endorse affirmative action is influenced by the match between beneficiary group and the attributional underpinnings of the programs, endorsement of four programs that could be used to benefit either women or men were assessed among 95 undergraduate students in Ontario, Canada. Students preferred the use of a remedial program that suggested that beneficiaries are under-qualified and need to develop job relevant skills for female versus male beneficiaries. This was driven by perceptions of the effectiveness of the program. For male beneficiaries, participants were more supportive of a mentorship development program that implied the necessity of structural change than they were of the remedial program. These effects were independent of participant gender.