Browsing by Subject "substance use"
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Item Examining the Nature, Origins, and Health Consequences of Attachment-Related Individual Differences in the Emotion Regulation Process(2014-07) Fillo, JenniferIndividuals vary in their tendency to habitually adopt different emotion-regulation strategies, such as cognitive reappraisal and suppression (Gross & John, 2003). These strategies have implications for individuals' subjective, expressive, and physiological reactions to emotions, with certain emotional profiles being considered "healthier" than others (John & Gross, 2004). A key direction for research in this area is the identification of individual differences that can explain how and why individuals develop these tendencies. This information could help researchers and clinicians better predict and potentially curtail the negative consequences associated with some emotion-regulation tendencies. The present research examines individual differences in attachment orientations as one such explanation. According to attachment theory, individuals' histories of interactions with caregivers throughout life shape their relational orientations, as well as their motivations and abilities for coping with stressful events (Bowlby, 1969). Study 1 examined relations between attachment orientations and self-reported emotion-regulation tendencies, as well as experimentally tested attachment-based individual differences in the emotion regulation process by examining subjective, expressive, and physiological emotional responses to an emotion-eliciting film clip. Attachment avoidance and anxiety were associated with a number of similar emotion-regulation difficulties, but specific approaches to regulating emotions. In the experimental portion, the nature and effectiveness of specific emotion-regulation strategies varied across levels of avoidance and anxiety. Additionally, avoidant individuals showed some evidence of spontaneous emotion-regulation attempts, even when they were given no specific emotion-regulation instructions. Study 2 replicates and extends Study 1 by examining the developmental antecedents and long-term health consequences of these individual differences in emotion regulation, using data collected as part of the Minnesota Longitudinal Study of Risk and Adaptation. It examined the potential mediating role of emotion-regulation difficulties in the link between attachment representations and later substance use (i.e., alcohol consumption, tobacco use). There was an indirect effect of attachment representations on later alcohol consumption through impulse control difficulties and limited access to emotion-regulation strategies. Attachment representations directly predicted tobacco use, but this relation was not mediated by difficulties with emotion regulation. As a whole, this research reveals important information about the nature, origins, and health consequences of attachment-based individual differences in emotion regulation.Item Know Thyself: Tracing Insight Along the Psychosis Spectrum(2021-08) Mervis, JoshuaThe studies presented here examine three domains of insight along the psychosis spectrum. The first domain is clinical insight, which is the awareness of a mental illness, its impacts, and the need to ameliorate those impacts. The second is cognitive insight, which is understanding thought processes as fallible. The third is introspective accuracy. which refers to domain-specific self-assessment. The first study investigates introspective accuracy for substance use in the context of a year of treatment for people with first episodes of psychosis. The second study uses geometric dimension reduction to examine cognitive and clinical insight together and their relationship to forms of cognition in people with prolonged psychosis. Finally, the third study uses probabilistic dimension reduction as a tool for exploratory translational research on psychotic-like experiences, cannabis use, and insight in the general population. Results for insight across all three studies indicated one paradoxical effect, one effect for a form of cognition, and a mixed finding. The first study found a paradoxical effect for IA, such that those who had poor IA that were overconfident had greater symptom remission midway through treatment for an FEP. The second study presented here found that the combination of poorer clinical and cognitive insight accompanied poorer metacognition, whereas better clinical insight accompanied better metacognition regardless of cognitive insight. The third study had mixed results that show poorer insight sometimes accompanies greater symptoms, which is consistent with the findings of our review even though it did not cover general population samples. Overall, all three studies presented here add to the existing evidence for positive, paradoxical, and mixed findings for the relationships between insight and other constructs of clinical interest. Finally, future directions in terms of conceptual and treatment implications are discussed.Item The Relationship Between Adolescent Alcohol Use And Functioning In Later-Young Adulthood: Disentangling Confounding Influences From Causal Processes Using A Twin Sample(2015-11) Waldron, JordanThe vast majority of individuals initiate alcohol consumption for the first time in adolescence, and heavy alcohol use during this time period is relatively common. Given the widespread nature of its use and evidence that adolescents may be especially vulnerable to its effects, there is concern about the long-term detrimental impact of adolescent drinking on adult functioning. Unfortunately, the research surrounding this topic has been affected by limited attention to consequences outside of adult substance use, as well as a lack of methodology that allows for conclusions about a causal impact of adolescent drinking, which is especially problematic given evidence suggesting that familial influences such as genetic risk may confound the relationship. A series of three studies were conducted to address these limitations and elucidate the nature of the relationship between adolescent drinking and later functioning. All three studies utilized a prospective longitudinal sample drawn from the Minnesota Twin Family Study, consisting of 2,764 twins assessed in two cohorts at regular follow-ups from age 17 to age 29 (older cohort) or age 11 to age 29 (younger cohort). A broad range of adult measures was included tapping substance use and substance use disorders, antisocial behavior, mental health issues and personality, socioeconomic status, and social functioning. Using biometric modeling, the first study examined the familial influences on the association between a measure of adolescent alcohol consumption and each of the measures of adult adjustment. Delineating the source of the covariation extends the literature by furthering understanding of the mechanisms that link adolescent drinking with later functioning while also providing an empirical justification for the use of methodologies that control for familial influences. The results revealed that genetic factors and unique environmental influences were generally most important in explaining the relationship between adolescent drinking and later functioning. In the second study, evidence for a causal relationship between adolescent drinking and adult outcomes was examined through a series of co-twin control analyses. Measures of early initiation of drinking and intoxication, as well as an index of level of alcohol consumption, were all predictive of the adult measures, but the co-twin control analyses suggested that many of the individual associations were influenced by familial confounding. However, relationships consistent with causal processes were present for each of the adolescent drinking measures across multiple domains of adult functioning, with significant effects most frequently observed with the measure of adolescent alcohol consumption. In the third study, mechanisms grounding the relationship between adolescent drinking and later functioning were further examined by focusing on mediators between adolescent drinking and later-young adulthood. Drinking in emerging adulthood partially mediated the relationship with all of the adult domains, except for socioeconomic status, and co-twin control analyses revealed that this mediating effect was generally consistent with a causal process. In contrast, when controlling for drinking during emerging adulthood, the unique effects of adolescent drinking on later functioning were attenuated, although there were some specific effects for substance use measures. In summary, this investigation extends the current literature by demonstrating that adolescent drinking is associated with multiple domains of later-young adult functioning, genetic factors strongly influence the association, evidence is consistent with the conclusion that adolescent alcohol consumption has a causal effect on a limited set of facets of adult adjustment, and continued drinking in emerging adulthood mediates the relationship.Item Substance Use and Retrospective Adverse Childhood Experiences: An Ambulatory Assessment of Cortisol Awakening Response(2022-06) Ravet, Mariah KAlthough support for the relationship between early life stress and substance use in adulthood is well documented, there is a paucity of research examining the relationship between adverse childhood experiences (ACEs), substance use, and cortisol awakening response (CAR) in college-aged adults. Thus, the current studies were designed to address this gap in the literature. The specific aims of this project included determining the relationship between ACE exposure and risky substance use, whether perceived stress mediates the relationship between ACEs and substance use, whether the diurnal cortisol rhythm varies by substance use status and sex, and whether CAR varies by ACE exposure. In Study One, 265 college students completed measures of ACEs, substance use, perceived stress, and mental health. In Study Two, 55 participants self-administered salivary cortisol samples within their place of residence and completed inventories for ACEs, substance use, and mental health. For Study One, perceived stress levels were higher among those with high risk of hazardous drinking, high e-cigarette use, and daily THC/marijuana use. Results also revealed a significant positive relationship between ACEs and drinking consequences and e-cigarette use as well as a mediating role of perceived stress in the relationship between ACEs and drinking consequences. In Study Two, results revealed a medium effect of cortisol collection time point by sex and by risky substance use status. Further, results indicated that those with high ACEs exhibited blunted cortisol levels immediately upon waking compared to those with low ACE exposure. This study contributes to the growing literature base by using a well-established cortisol collection method that has been previously unexplored in the context of ACEs and substance use. The use of self-collected cortisol samples to identify students at risk for hazardous substance use and other health-compromising behaviors has important implications for tailored prevention efforts for those with a history of ACEs.Item Substance Use Transmission and Outcomes: Using Genetically Informative Research Designs for Causal Inference with Observational Data(2019-07) Saunders, GretchenOne of the most difficult, yet arguably the most important aspect of research is the issue of causal inference using observational data. For phenotypes like substance use, in which it is impractical or unethical to conduct randomized controlled trials, understanding the causal mechanisms that influence substance use behavior as well as the outcomes caused by these behaviors remains difficult. The current work explores how genetically related samples can be exploited to better understand the causal effects of environmental factors on adult outcomes related to early substance use. In Study 1, polygenic risk scores for alcohol and tobacco use are used to identify a genetic nurture effect of parental smoking initiation on offspring alcohol and tobacco use in a large parent-offspring sample. The effect of parental genotype on offspring use is mediated by parental socioeconomic status (SES), suggesting that rearing SES, or the resources higher SES provide, may causally influence substance use in adolescence. Study 2 is a methodological exploration of co-twin control (CTC) designs, in which an exposure- outcome effect is decomposed into a within-twin pair and between-twin pair effect. A limitation of the CTC design is that it cannot implicitly control for environmental factors that are not perfectly shared within a twin pair, the presence of which may bias CTC findings. We use analytical derivations and simulations to show that while inclusion of a covariate as a proxy measure of a non-shared environmental confounder will always reduce bias, results from CTC studies will continue to be biased away from the null to at least some extent in most practical situations. Interpretation and suggestions for use of CTC, and more generally between-within, models are discussed. Finally, in Study 3 we use a large sample of twins to investigate the adult socioeconomic outcomes related to adolescent substance use. Using the co-twin control (CTC) design we find that within monozygotic (MZ) twin pairs, who share all genetic and common environmental factors, the twin who consumes more tobacco and alcohol in adolescence has lower educational attainment and occupational status in adulthood compared to their lesser using co-twin, consistent with a causal effect of early substance use on later socioeconomic outcomes. We focus on interpretation of these results in the context of findings from Study 2.