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.     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

Instantiation is not partial identity

In order to avoid the problems faced by standard realist analyses of the “relation” of instantiation, Baxter and, following him, Armstrong each analyze the instantiation of a universal by a particular in terms of their partial identity. I introduce two related conceptions of partial identity, one mereological and one non-mereological, both of which require at least one of the relata of the partial identity “relation” to be complex. I then introduce a second non-mereological conception of partial identity, which allows for both relata to be simple. I take these three conceptions to exhaust the plausible ways of construing two entities as being partially identical. I then argue that there is no analysis (including those offered by Baxter and Armstrong) of a universal and a particular as being partially identical consistent with any of these three conceptions that (i) is coherent, (ii) is consistently realist, (iii) does not lead to absurd consequences, and (iv) offers a “solution” to the problem of instantiation that avoids the problems with the other standard realist responses. In so arguing, I offer a criticism of the analysis of instantiation as partial identity that is independent of the standard criticism that it entails the necessity of predication.     

Introspection and inference

In this paper I develop the idea that, by answering the question whether p, you can answer the question whether you believe that p. In particular, I argue that judging that p is a fallible yet basic guide to whether one believes that p. I go on to defend my view from an important skeptical challenge, according to which my view would make it too easy to reject skeptical hypotheses about our access to our minds. I close by responding to the opposing view on which our beliefs themselves constitute our only source of first-person access to our beliefs.     

Matching Methods for Selection of Participants for Follow-Up

This work examines ways to make the best use of limited resources when selecting individuals to follow up in a longitudinal study estimating causal effects. In the setting under consideration, covariate information is available for all individuals but outcomes have not yet been collected and may be expensive to gather, and thus only a subset of the comparison participants are followed. Expressions in Rubin and Thomas (1996) Rubin, D. B. and Thomas, N. 1996. Matching using estimated propensity scores, relating theory to practice.. Biometrics, 52: 249–264. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] show the benefits that can be obtained, in terms of reduced bias and variance of the estimated treatment effect, of selecting comparison individuals well matched to those in the treated group compared with a random sample of comparison individuals. We primarily consider nonexperimental settings but also consider implications for randomized trials. The methods are illustrated using data from the Johns Hopkins University Baltimore Prevention Program, which included data collection from age 6 to young adulthood of participants in an evaluation of 2 early elementary-school-based universal prevention programs.     

Conceptual Analysis and Epistemic Progress

This essay concerns the question of how we make genuine epistemic progress through conceptual analysis. Our way into this issue will be through consideration of the paradox of analysis. The paradox challenges us to explain how a given statement can make a substantive contribution to our knowledge, even while it purports merely to make explicit what one’s grasp of the concept under scrutiny consists in. The paradox is often treated primarily as a semantic puzzle. However, in “Sect. 1” I argue that the paradox raises a more fundamental epistemic problem, and in “Sects.1 and 2” I argue that semantic proposals—even ones designed to capture the Fregean link between meaning and epistemic significance—fail to resolve that problem. Seeing our way towards a real solution to the paradox requires more than semantics; we also need to understand how the process of analysis can yield justification for accepting a candidate conceptual analysis. I present an account of this process, and explain how it resolves the paradox, in “Sect. 3”. I conclude in “Sect. 4” by considering the implications for the present account concerning the goal of conceptual analysis, and by arguing that the apparent scarcity of short and finite illuminating analyses in philosophically interesting cases provides no grounds for pessimism concerning the possibility of philosophical progress through conceptual analysis.     

Major memory for microblogs

Online social networking is vastly popular and permits its members to post their thoughts as microblogs, an opportunity that people exploit, on Facebook alone, over 30 million times an hour. Such trivial ephemera, one might think, should vanish quickly from memory; conversely, they may comprise the sort of information that our memories are tuned to recognize, if that which we readily generate, we also readily store. In the first two experiments, participants’ memory for Facebook posts was found to be strikingly stronger than their memory for human faces or sentences from books—a magnitude comparable to the difference in memory strength between amnesics and healthy controls. The second experiment suggested that this difference is not due to Facebook posts spontaneously generating social elaboration, because memory for posts is enhanced as much by adding social elaboration as is memory for book sentences. Our final experiment, using headlines, sentences, and reader comments from articles, suggested that the remarkable memory for microblogs is also not due to their completeness or simply their topic, but may be a more general phenomenon of their being the largely spontaneous and natural emanations of the human mind.     

Negative Affect Shares Genetic and Environmental Influences with Symptoms of Childhood Internalizing and Externalizing Disorders

The co-occurrence of internalizing and externalizing disorders suggests that they may have common underlying vulnerability factors. Research has shown that negative affect is moderately positively correlated with both internalizing and externalizing disorders in children. The present study is the first to provide an examination of negative affect in relation to a wide spectrum of childhood internalizing and externalizing problems using a biometric model. This study extends prior findings of more narrowly focused associations by using a factor approach including multiple disorders. The sample for this study included families of 691 same-sex 7- to 13-year old twin pairs. A multifactorial independent pathway model was used to examine the genetic and environmental influences underlying the covariation of parent-reported negative affect, internalizing symptoms, and externalizing symptoms. Results of the current study suggest that negative affect shares genetic and environmental influences with both internalizing and externalizing disorders in childhood. These common influences may partially explain their comorbidity. Understanding that negative affect is at least one contributor to the covariation among these disorders may highlight avenues for early risk assessment, intervention, and perhaps prevention.     

Lashing Out after Stewing over Public Insults: The Effects of Public Provocation,Provocation Intensity,and Rumination on Triggered Displaced Aggression

Four studies present the first evidence showing that public (vs. private) provocation augments triggered displaced aggression by increasing the perceived intensity of the provocation. This effect is shown to be independent of face‐saving motivation. Following a public or private provocation, Study 1 participants were induced to ruminate or were distracted for 20 min. They then had an opportunity to aggress against another person who either acted in a neutral or mildly annoying fashion (viz. triggering event). As expected, the magnitude of the greater displaced aggression of those who ruminated before the triggering event compared with those distracted was greater under public than private provocation. Study 2 replicated the findings of Study 1 and confirmed that public provocations are experienced as more intense. Studies 3 and 4 both manipulated provocation intensity directly to show that it mediated the moderating effect of public/private provocation found in Study 1. The greater intensity of a public provocation increases reactivity to a subsequent trigger, which in turn, augments triggered displaced aggression. Aggr. Behav. 39:13‐29, 2013. © 2012 Wiley Periodicals, Inc.     

Projects in progress

This department publishes articles on large-scale projects in which logic plays a significant role, especially editions of collected or selected works. In addition to factual and historical details, articles describe points of historiography and scholarship which are of more general interest. Articles should be submitted to the Editor.